Title |
Esophageal perforation: diagnostic work-up and clinical decision-making in the first 24 hours
|
---|---|
Published in |
Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, October 2011
|
DOI | 10.1186/1757-7241-19-66 |
Pubmed ID | |
Authors |
Jon Arne Søreide, Asgaut Viste |
Abstract |
Esophageal perforation is a rare and potentially life-threatening condition. Early clinical suspicion and imaging is important for case management to achieve a good outcome. However, recent studies continue to report high morbidity and mortality greater than 20% from esophageal perforation. At least half of the perforations are iatrogenic, mostly related to endoscopic instrumentation used in the upper gastrointestinal tract, while about a third are spontaneous perforations. Surgical treatment remains an important option for many patients, but a non-operative approach, with or without use of an endoscopic stent or placement of internal or external drains, should be considered when the clinical situation allows for a less invasive approach. The rarity of this emergency makes it difficult for a physician to obtain extensive individual clinical experience; it is also challenging to obtain firm scientific evidence that informs patient management and clinical decision-making. Improved attention to non-specific symptoms and signs and early diagnosis based on imaging may translate into better outcomes for this group of patients, many of whom are elderly with significant comorbidity. |
X Demographics
Geographical breakdown
Country | Count | As % |
---|---|---|
India | 1 | 50% |
United States | 1 | 50% |
Demographic breakdown
Type | Count | As % |
---|---|---|
Members of the public | 1 | 50% |
Practitioners (doctors, other healthcare professionals) | 1 | 50% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
Italy | 1 | <1% |
India | 1 | <1% |
Czechia | 1 | <1% |
Iceland | 1 | <1% |
Russia | 1 | <1% |
United States | 1 | <1% |
Unknown | 155 | 96% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Other | 20 | 12% |
Student > Bachelor | 19 | 12% |
Researcher | 17 | 11% |
Student > Postgraduate | 13 | 8% |
Student > Master | 12 | 7% |
Other | 36 | 22% |
Unknown | 44 | 27% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 95 | 59% |
Agricultural and Biological Sciences | 3 | 2% |
Nursing and Health Professions | 3 | 2% |
Biochemistry, Genetics and Molecular Biology | 2 | 1% |
Engineering | 2 | 1% |
Other | 6 | 4% |
Unknown | 50 | 31% |