ESOPHAGEAL-PERFORATION - A CONTINUING CHALLENGE
ESOPHAGEAL-PERFORATION - A CONTINUING CHALLENGE
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DOI：
10.1016/0003-4975(92)90294-e
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发表时间：
1992-03-01
影响因子：
4.6
通讯作者：
GINSBERG, RJ
中科院分区：
文献类型：
--
作者：
JONES, WG;GINSBERG, RJ
食管穿孔仍然是诊断和治疗的挑战。 目前，穿孔最常见的原因是食管内器械，并且随着内窥镜手术的使用越来越频繁，食管穿孔的发生率也随之增加。 诊断依赖于对临床特征的高度怀疑和认识，并通过食管造影或内窥镜检查确诊。 食管穿孔后的结果取决于损伤的原因和位置、潜在食管疾病的存在以及损伤和开始治疗之间的时间间隔。 穿孔的强化一期修复是食管穿孔手术治疗中最常用和优选的方法。 由抗生素和肠外营养组成的非手术治疗对于满足适当选择标准的有限食管损伤特别成功。
Perforation of the esophagus remains a diagnostic and therapeutic challenge. Currently, the most common cause of perforation is instrumentation of the esophagus, and the incidence of esophageal perforations has increased as the use of endoscopic procedures has become more frequent. Diagnosis depends on a high degree of suspicion and recognition of clinical features, and is confirmed by contrast esophagography or endoscopy. Outcome after esophageal perforation is dependent on the cause and location of the injury, the presence of underlying esophageal disease, and the interval between injury and initiation of treatment. Reinforced primary repair of the perforation is the most frequently employed and preferable approach to the surgical management of esophageal perforations. Nonoperative management consisting of antibiotics and parenteral nutrition is particularly successful for limited esophageal injuries meeting proper selection criteria.