Morbidity and mortality of oesophageal perforation.

Thirty-three patients with oesophageal perforation seen within a 20-year period are reviewed. Endoscopic perforation in patients with neoplastic disease of the oesophagus carried a 100% mortality despite early diagnosis and immediate resection of the growth. Only two deaths occurred after instrumental perforation of the thoracic oesophagus for benign pathology in patients who were in the extremes of life. Twelve cases with spontaneous perforation were seen. Although the mortality figure of only 8% was encouraging, the morbidity in terms of postoperative complications was considerable, occurring in all but one of the survivors. The importance of early diagnosis and adequate treatment in relation to postoperative morbidity and mortality is discussed.