OBJECTIVE: To evaluate the management of cervical esophageal perforation in adult patients. MATERIAL AND METHODS: A retrospective clinical review was made of all cervical esophageal perforations diagnosed in adult patients in the ear, nose and throat department of Marqués de Valdecilla Hospital (Santander, Spain) between January 1989 and December 1996. Age, sex, symptoms, cause of perforation, time to diagnosis, diagnostic studies, treatment, and evolution were obtained from the clinical records. RESULTS: Eleven patients with perforation of the cervical esophagus, age range 38 to 84 years, were seen in the study period. In 8 cases, perforation was caused by a foreign body and 3 cases were iatrogenic (after rigid esophagoscopy). The most frequent symptoms of presentation were cervical pain and odinophagia. Nine patients were treated with broad-spectrum intravenous antibiotic therapy and no oral feeding. Two patients were treated surgically. There were no complications or need for further surgery in any case. CONCLUSIONS: Small perforations of the cervical esophagus in adult patients produced by foreign body impaction or rigid esophagoscopy can be managed by observation, restricted oral intake, and intravenous antibiotics. Neck exploration should be reserved for patients with signs and symptoms of cervical or mediastinal infection.
OBJECTIVE: To evaluate the management of cervical esophageal perforation in adult patients. MATERIAL AND METHODS: A retrospective clinical review was made of all cervical esophageal perforations diagnosed in adult patients in the ear, nose and throat department of Marqués de Valdecilla Hospital (Santander, Spain) between January 1989 and December 1996. Age, sex, symptoms, cause of perforation, time to diagnosis, diagnostic studies, treatment, and evolution were obtained from the clinical records. RESULTS: Eleven patients with perforation of the cervical esophagus, age range 38 to 84 years, were seen in the study period. In 8 cases, perforation was caused by a foreign body and 3 cases were iatrogenic (after rigid esophagoscopy). The most frequent symptoms of presentation were cervical pain and odinophagia. Nine patients were treated with broad-spectrum intravenous antibiotic therapy and no oral feeding. Two patients were treated surgically. There were no complications or need for further surgery in any case. CONCLUSIONS: Small perforations of the cervical esophagus in adult patients produced by foreign body impaction or rigid esophagoscopy can be managed by observation, restricted oral intake, and intravenous antibiotics. Neck exploration should be reserved for patients with signs and symptoms of cervical or mediastinal infection.