FA07.02: ESOPHAGEAL PERFORATION: A RETROSPECTIVE, SINGLE CENTER OUTCOMES. (14th September 2018)

• Record Type: Journal Article
• Authors: Kovacs, Balazs; Masuda, Takahiro; Bremner, Ross; Smith, Michael; Huang, Jasmine; Hashimi, Samad; Patel, Chirag; Ahmed, Shair; Mittal, Sumeet
• Is Part Of: Diseases of the esophagus. Volume 31(2018)Supplement 1
• Page Start: 13
• Page End: 14
• Publication Date: 2018-09-14
• Subjects: Esophageal perforation -- esophageal stent; Esophagus -- Diseases -- Periodicals; 616.32
• DOI: 10.1093/dote/doy089.FA07.02
• Languages: English
• ISSNs: 1120-8694

Abstract

Abstract: Background: Esophageal perforation (EP) though uncommon has high morbidity and mortality. Aim of this study is to evaluate the outcomes at a tertiary referral hospital. Methods: After IRB approval patients with EP between May 2014 and Sept 2017 were identified. Retrospective chart review was done to collect data. Exclusion criteria were: age under 18, leak following esophageal resection and esophageal stenting in previous year. Pittsburgh esophageal perforation severity score (PS) was calculated for each patient. Results: During study period 56 patients (70% men) with EP met inclusion and exclusion criteria with a mean age and BMI of 60 Yrs. 27.1 kg/m2 respectively. Most common causes were iatrogenic (43%) and Boerhaave's (21%). Nearly 3/4th patients presented to the hospital within 24h of onset. The site of perforation was thoracic (67.9%), cervical (16.1%) and abdominal (16.1%). Overall mortality within 1 month was 5.7% (3 cases) compared to predicted (5.8 cases, 10.4%) based on Pittsburgh score ( P > 0.05). See Table 1 for PS at presentation, management and ICU stay. Conclusion: In our single center experience the leading cause of EP are iatrogenic injury and Boerhaave's syndrome. PS correlated well with need for aggressive surgical intervention and length of ICU stay. Use of endoluminal stents was higher than previously reported. Stents with or without additional surgical intervention can be a viable option in a subset of patients. Disclosure: All authors have declared no conflicts of interest.