Esophageal Perforation

An esophageal perforation is a rare occurrence that happens when you have a hole in your esophagus. Your esophagus is a tube that carries the food from your mouth to your stomach. If it has a hole or perforation, food or liquid can leak into the area surrounding your chest. This can cause infection and other problems.

At St. Elizabeth Healthcare, our thoracic experts have the skill and expertise to diagnose and treat issues that affect your esophagus – no matter how rare.

Symptoms of Esophageal Perforation

Pain is the main symptom of esophageal perforation.

If you have a perforation in the middle or lower-most portion of your esophagus, it could cause:

• Swallowing problems
• Chest pain
• Breathing issues
• Rapid heart rate
• Low blood pressure
• Fever
• Chills
• Vomiting blood
• Stiff neck

Causes of Esophageal Perforation

While very rare, the most common cause of esophageal perforation is injury that’s caused during another medical procedure.

Other causes of esophageal perforation include:

• Tumor
• Gastric reflux
• Previous esophagus surgery
• Swallowing damaging materials
• Trauma to the esophagus
• Violent vomiting
• Food impaction or foreign body – food gets stuck in the esophagus and won’t pass

Diagnosing Esophageal Perforation

These tests may include a chest X-ray, a CT scan or an esophagram.

Treating Esophageal Perforation

Esophageal perforation can be life threatening and needs to be treated immediately. Surgery is the most common way of treating your esophageal perforation, depending on the size and location of the affected area. The leak may only need a simple repair or it may require removal of a portion of your esophagus. Our multidisciplinary team will determine the best course of action to meet your individual health needs.

In addition to surgery, treatment may include:

• IV to deliver fluids and prevent dehydration.
• IV antibiotics to prevent infection.
• Chest tube to drain any fluid that has collected around your lungs.
• Intervention procedure/surgery to close the perforation which can include:
  • Endoscopic treatment with an esophageal stent – this is performed during an endoscopy.
  • Surgical closure – may be needed if unable to treat endoscopically or clinical condition requires it. The type of surgery depends on the size and location of the injury. It may need a repair or the removal of a portion of the esophagus.