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KMID : 0356019920070020155
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Koean Jounral of Critical Care Medicine
1992 Volume.7 No. 2 p.155 ~ p.164
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Esophageal Perforation
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Abstract
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Twenty-five patients with perforation of esophagus were managed at Pusan National University Hospital, from 1981 to 1991. The hospital coures of the patients was evaluated with a special emphasis on the cause and location of perforation, clinical
presentation, time elapsed from perforation to treatment, method of treatment, and outcome. Patients with anastomotic leak and cancer were excluded. The perforation was iatrogenic in 10 patients, spontaneous in 8, ingestion of foreign body in 5,
and
traumatic in 2. There were 11 cervical perforations, 4 upper thoracic perforations, and 10 lower thoracic perforations. Chest pain, fever, and dyspnea were frequent symptoms. Esophagography was most diagnostic(23 patients) but thoracentesis was
of
little diagnostic aid. Twenty-two patients received operation, including primary closure and drainage (6 patients), drainage alone()13), and resection (3). Delay for more than 24 hours resulted in 66.7% mortality (4/6). Three patients were
treated
nonoperatively. 6 out of 25 patients died and overall mortality rate was 24%.
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