The oesophagus is a smooth muscle looks like a tube that moves food from the pharynx to the stomach. Oesophageal perforation means forming a hole in the oesophagus. Perforation of the oesophagus is rare, but when it occurs it is a serious medical condition. As a result, food might leak and sometimes it even leaks the digestive fluid into the chest.

Usually, oesophagal perforation is corrected surgically. This condition can become life-threatening if left untreated.

causes of oesophagal perforation

The oesophagus is a long smooth tube connecting your mouth to the stomach. A perforation is a hole that can develop in any part along the tube. An injury to the oesophagus is the common cause of perforation occurs during another medical procedure. There are some other causes that might lead to oesophagal perforation which include:

• Throat tumours
• Throat ulcers caused by gastroesophageal reflux disease (GERD)
• Swallowing a foreign object, acid, or chemicals accidentally
• physical injury to the neck
• violent vomiting

Symptoms of oesophagal perforation

Pain is the major symptom of oesophagal perforation. You will experience pain in the area where the perforation(hole) is located. Sometimes, you may also experience chest pain. Some other symptoms include:

• Difficulty in swallowing
• Breathing problems
• Difficulty to speak
• shoulder pain, neck pain, upper or lower back pain. pain may increase even more when lying down flat
• Vomiting followed by severe chest pain
• Fever
• Bloody vomitings (rare)
• Subcutaneous emphysema

In most cases treatment delayed due to misdiagnosis. If you find any of the symptoms, consult gastroenterologist doctor right away for immediate medical attention because you are at risk of having perforated oesophagus.

Treatment for oesophagal perforation

You must get treatment as soon a perforation is diagnosed to prevent infection. The earlier you get treatment, the better the result will be. Ideally, a gastroenterology doctor would provide treatment within 24 hours of diagnosis.

If the oesophagal perforation is not treated immediately, it may result in a permanent stricture or narrowing of the oesophagus. This condition can cause swallowing and breathing more difficult.

Treatment might include:

• Fluids are provided through a vein (IV)
• Antibiotics to prevent infections
• Draining the fluid surrounding the lungs with a chest tube
• Mediastinoscopy

A stent is placed in the oesophagus if the fluid leaks in small amounts. This might help to avoid surgery. Surgery is often needed to repair a perforation in the middle or bottom portions of the oesophagus.

Often surgery is required to fix the perforation when it is in the middle or bottom parts of the oesophagus. The choice of treatment based on the size, site of perforation, the general health condition of the patient etc. The surgical techniques used to repair oesophagal perforation:

• Diversion and exclusion
• Resection of oesophagal
• Thoracoscopic repair using minimally invasive surgery
• Thoracoscopic decortication
• Thoracotomy
• Endoscopic stenting
• Endoscopic suture ligation