Esophageal Perforation Surgical Management

the back or left shoulder with signs of peritoneal irritation. Early diagnosis are important step in patients with Esophageal perforation, The diagnostic study of choice in any patient suspected of having an esophageal perforation is a contrast radiograph of the esophagus. A water soluble contrast esophagogram followed by barium, if necessary, is diagnostic in 90% of patients. CT scan of the chest and upper abdomen with oral contrast is also used with more frequency are more sensitive to localize site of perforation ,area of necrosis or fluid collection in mediastinal or pleural cavity. The plain chest radiograph less sensitive may appear normal early after esophageal perforation but however present pneumomediastinum, subcutaneous emphysema, pleural effusion, and hydropneumothorax, these findings in chest x. Ray highly suggestive of esophageal perforation [2,3]. Treatment should also be stepwise with consideration given to: patients clinical status and stability, Time since perforation, Location/size of the perforation, the extent of tissue necrosis and degree of contamination, the presence of underlying esophageal disease or disorder (Barrett’s,malignancy,achalasia ..ets). If esophageal perforation is suspected, immediate treatment should begin with cessation of all oral intake, intravenous fluid ABSTRACT The esophageal perforation remains a potentially devastating condition. Rapid diagnosis and therapy provide the best chance for survival; however, delay in diagnosis is common, resulting in substantial morbidity and mortality. This article discusses the diagnosis and Surgical Management for this potentially lethal Gastrointestinal condition.