Esophageal Perforation

Overview


Plain-Language Overview

Esophageal perforation is a serious condition where a hole or tear develops in the esophagus, the tube that carries food from the mouth to the stomach. This damage affects the digestive system and can cause food, liquids, and stomach acid to leak into the surrounding chest area. This leakage can lead to severe chest pain, difficulty swallowing, and infection. Because the esophagus is close to important organs like the lungs and heart, this condition can quickly become life-threatening. Prompt medical attention is critical to prevent complications such as sepsis or breathing problems.

Clinical Definition

Esophageal perforation is defined as a full-thickness tear or rupture of the esophageal wall, resulting in leakage of esophageal contents into the mediastinum or pleural cavity. It most commonly occurs due to iatrogenic causes such as endoscopic procedures, spontaneous rupture (Boerhaave syndrome) from forceful vomiting, or trauma. The condition leads to severe mediastinitis, systemic infection, and can rapidly progress to sepsis and shock if untreated. Clinical features include acute chest pain, subcutaneous emphysema, and signs of systemic toxicity. Early recognition and diagnosis are crucial due to the high morbidity and mortality associated with delayed treatment.

Clinical Presentation


Diagnostic Workup


Pathophysiology


Treatments


Prevention


Outcome & Complications


Differential Diagnoses


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