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Management iatrogener Ösophagusperforationen

Management of iatrogenic esophageal perforations

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Zusammenfassung

Hintergrund

Die iatrogene Ösophagusperforation ist noch immer ein potenziell lebensbedrohliches Krankheitsbild.

Patienten und Ergebnisse

Anhand von 6 Fallbeispielen stellen wir unterschiedliche Therapiestrategien vor und gehen insbesondere auf neue interdisziplinäre Behandlungsmöglichkeiten ein. Zwei Patienten mit Perforation im Bereich des zervikalen Ösophagus wurden operiert und bei einem weiteren Patienten wurde die Perforation mit Fibrinkleber abgedichtet. Drei Patienten mit Perforation des thorakalen Ösophagus wurden mit selbstexpandierenden Plastikstents versorgt.

Fazit

Die chirurgische Therapie der Ösophagusperforation gilt weiterhin als Goldstandard, von dem nur in interdisziplinären Einzelfallentscheidungen abgewichen werden sollte. Es werden jedoch zunehmend positive Ergebnisse bei konservativ-endoskopischem Vorgehen vor allem bei thorakalen Ösophagusperforationen berichtet.

Abstract

Background

Iatrogenic esophageal perforations are still a life-threatening clinical entity.

Patients and results

We present the case reports of six patients to demonstrate different treatment options and we focus on new therapeutic strategies which have evolved in the interdisciplinary management of iatrogenic esophageal perforations. Two patients with perforations in the cervical esophagus were operated and in another patient the perforation was closed with fibrin glue. Three patients with perforations in the thoracic esophagus were treated with self-expandable plastic stents.

Conclusion

The surgical therapy of esophageal perforations still is regarded to be the gold standard and nonadherence should only be considered based on interdisciplinary decisions in individual cases. However, positive results are increasingly being reported for conservative endoscopic treatment, particularly for thoracic perforations.

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Authors and Affiliations

  1. Klinik für Gastroenterologie und Hepatologie, Universitätsklinik Essen, Essen, Deutschland

    K. Radecke & T. Zöpf

  2. Universitäts-Hals-, Nasen-, Ohrenklinik Bochum am St. Elisabeth Hospital, Bochum, Deutschland

    H. Sudhoff

  3. Klinik für Allgemein- und Transplantationschirurgie, Universitätsklinik Essen, Essen, Deutschland

    H. Lang

  4. Universitäts-Hals-, Nasen-, Ohrenklinik, Hufelandstraße 55, 45122, Essen, Deutschland

    J. Lautermann, A. Neumann & K. Jahnke

Authors
  1. J. Lautermann
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  2. K. Radecke
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  3. H. Sudhoff
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  4. H. Lang
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  5. A. Neumann
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  6. K. Jahnke
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  7. T. Zöpf
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Corresponding author

Correspondence to J. Lautermann.

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Lautermann, J., Radecke, K., Sudhoff, H. et al. Management iatrogener Ösophagusperforationen. HNO 55, 723–728 (2007). https://doi.org/10.1007/s00106-006-1456-x

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  • DOI: https://doi.org/10.1007/s00106-006-1456-x

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