Selective Nonoperative Management of Contained Intrathoracic Esophageal Disruptions

John L. Cameron, Richard F. Kieffer, Thomas R. Hendrix, Denis G. Mehigan, R. Robinson Baker

Research output: Contribution to journalArticlepeer-review

Abstract

Eight patients with intrathoracic esophageal disruptions were managed nonoperatively and without pleural drainage. Criteria for nonoperative treatment included the following: disruption contained in the mediastinum or between the mediastinum and visceral lung pleura; drainage of the cavity back into the esophagus; minimal symptoms; and minimal signs of clinical sepsis. Cause of the esophageal perforation was pneumostatic dilatation (1 patient), vomiting (2), and a leak following esophageal operation (5). Antibiotics were administered intravenously to all patients; hyperalimentation was accomplished intravenously in 5, and nasogastric suction was used in only 1. The cavities contracted and the esophageal leaks sealed in all instances. Time before oral intake was resumed ranged from 7 to 38 days (average, 18 days). Days until discharge ranged from 15 to 52 days (average, 28 days).

Original languageEnglish (US)
Pages (from-to)404-408
Number of pages5
JournalAnnals of Thoracic Surgery
Volume27
Issue number5
DOIs
StatePublished - Jan 1 1979

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

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