Esophageal Perforation in Children: Experience in Kurdistan Center for Gastroenterology and Hepatology/Iraq

作     者：Adnan M. H. Hamawandi Aram Baram Ali A. G. Ramadhan Taha A. Karboli Abdulsalam Y. Taha Ako Anwar 

作者机构：Department of Anasthesia Sulaimani Teaching Hospital Kurdistan Center for Gastroenterology and Hepatology Sulaymaniyah Iraq Department of Medicine School of Medicine Faculty of Medical Sciences University of Duhok Kurdistan Center for Gastroenterology and Hepatology Duhok Iraq Department of Medicine School of Medicine Faculty of Medical Sciences University of Sulaimani Kurdistan Center for Gastroenterology and Hepatology Sulaymaniyah Iraq Department of Pediatrics School of Medicine Faculty of Medical Sciences University of Sulaimani Kurdistan Center for Gastroenterology and Hepatology Sulaymaniyah Iraq Department of Surgery School of Medicine Faculty of Medical Sciences University of Sulaimani Sulaimani Teaching Hospital Sulaymaniyah Iraq 

出 版 物：《Open Journal of Gastroenterology》 (肠胃病学期刊（英文）)

年 卷 期：2014年第4卷第5期

页      面：221-227页

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

主　　题：Dilatation Esophageal Perforation Children Conservative Management Sulaimani 

摘      要：Background: Esophageal perforation is a rare, but potentially life threatening injury. The etiology and management of this condition have changed overtime. Iatrogenic causes are increasingly recognized and management is evolving towards more conservative approaches. Objective: To review our experience in the management of esophageal perforation in pediatric patients. Patients and methods: This retrospective study was conducted in the Kurdistan center for gastroenterology and hepatology in Sulaimani city. Review of records for cases of esophageal perforation during the period from January 2006 to October 2013 was performed. Results: Ten cases were found to have esophageal perforation. The causes of esophageal perforation were complications of endoscopic dilation for esophageal stricture (n = 7), button battery ingestion (n = 2), complication of esophagoscopy for corrosive injury (n = 1). The mean age was 42 months (range, 18 - 75 months). The diagnosis was made during the procedure in 6 cases, within 12 hours in 2 cases and late in the two cases of battery ingestion. Subcutaneous emphysema and respiratory distress were the main presenting features. The location of perforation was thoracic in 9 cases and cervical in 1 case. Conservative management was successful in 7 patients and surgical closure was done in two patients. One death has been reported. Conclusion: Iatrogenic causes were the most common causes of esophageal perforation. Conservative management with interventions guided by clinical response can have a favorable outcome and may become the best initial treatment strategy in the future. Further larger scale studies are recommended to establish the best protocol for conservative management.