Copyright@ Burkan Nasr | Biomed J Sci & Tech Res | BJSTR. MS.ID.006405. 31953 Mini Review ISSN: 2574 -1241 Esophageal Perforation Surgical Management Burkan Nasr* Consultant General and Laparoscopic surgery, Al Thawra Modern General/ Teaching Hospital, Sana`a and Suadi Hospital at Hajjah, Yemen *Corresponding author: Burkan Nasr Rashed Shaif, MD, FEBS, MRCS, FRCS, FACS, Consultant General and Laparoscopic surgery, Al Thawra Modern General/ Teaching Hospital,Sana`a and Suadi Hospital at Hajjah, Yemen E-mail: DOI: 10.26717/BJSTR.2021.40.006405 Introduction Esophageal perforation is commonly a life-threatening emergency. The majority of perforations (60%) are iatrogenic following endoscopy, esophageal dilatations. Trauma accounts for approximately 20% of esophageal perforations and spontaneous rupture for another 15%. Boerhaave’s syndrome, perforation of the esophagus, is caused by forceful or increased intra-abdominal pressure. Endoscopic injury typically occurs in two main site (proximal at esophageal entroitus and distally at site of pathology) the latter is the most common occurrence (80% cases). The reported mortality from treated esophageal perforation is 10% to 25%, when therapy is initiated within 24 hours of perforation, but it could rise up to 40% to 60% when the treatment is delayed beyond 48 hours [1]. Discussion Symptoms vary according to the location of perforation, size of the perforation, and time duration since injury. Cervical perforations may present with neck pain, dysphagia, and odynophagia. Palpation of the neck may reveal emphysematous crepitus. Thoracic perforations may present with substernal or epigastric pain as well as dysphagia. Abdominal perforations usually present with epigastric pain radiating to 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 ARTICLE INFO ABSTRACT Received: November 16, 2021 Published: November 22, 2021 Citation: Burkan Nasr. Esophageal Perforation Surgical Management. Biomed J Sci & Tech Res 40(1)-2021. BJSTR. MS.ID.006405. 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. Keywords: Esophageal perforation, Surgery in esophagus, Boerhaave’s syndrome, Esophageal cancer, Achalasia