Esophageal Rupture

Esophageal rupture is a challenging surgical disease process encountered by acute care surgeons, in which time is of the essence in order to prevent morbidity and mortality. Because the esophagus lies in three separate body cavities and perforations can occur anywhere along the entire length of the esophagus, patients may present with diverse and nonspecific symptoms. This, in turn, can lead to delays in diagnosis and treatment, despite modern clinical practice (Sdralis et al. Dis Esophagus 30, 1–6, 2017). Although rupture of the esophagus is a rare clinical entity, it is a highly lethal condition carrying a mortality rate between 20% and 30% in most series. Time from perforation to recognition remains the most important factor associated with complications and death (Abbas et al. Dig Surg 146, 749–756, 2009; Amudhan et al. Dig Surg 26, 322–328, 2009). However, a recent review of the available literature from 2005 to 2015 estimated the overall mortality to be 13.3% (Sdralis et al. Dis Esophagus 30, 1–6, 2017).This chapter is a review of management of esophageal rupture.