The management of esophageal perforations.

The successful handling of esophageal perforations has changed considerably during the past decade. Prior to 1940, esophageal perforation, regardless of the etiology involved, carried with it a fearful morbidity and unless surgical drainage was immediately instituted, a dependable mortality. In the recent literature, however, there have appeared several articles setting forth a newer concept regarding the management of known esophageal disruption with a sizable reduction in both morbidity and mortality statistics.’2’3’5 The recent and rapid strides in thoracic surgery greatly aided by the coincidental discovery and production of versatile and germ destroying antibiotics has been responsible in a large measure for the altered approach to this catastrophe. During the past four years 16 cases of esophageal perforation have been seen by us (D.J.D. and Paul C. Samson). The etiology concerned has varied widely and the treatment depended greatly on many factors which will be individually considered.