Oesophageal perforation: a diagnostic and therapeutic challenge in a resource limited setting. A report of three cases

Oesophageal perforation: a diagnostic and therapeutic challenge in a resource limited setting. A report of three cases

Oesophageal perforation is a condition associated with a high mortality. Its management is still controversial with operative treatment being favoured but a shift to conservative management is occurring. Very little exists in medical literature about its management in Sub-Saharan Africa, where the p...

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Bibliographic Details
Published in:Journal of cardiothoracic surgery Vol. 6; no. 1; p. 116
Main Authors: Balumuka, Deo D, Chalya, Phillipo L, Mahalu, William
Format: Journal Article
Language:English
Published: England BioMed Central Ltd 25-09-2011
BioMed Central
BMC
Subjects:
Antibiotics
Blood pressure
Case Report
Case studies
Caustics - poisoning
Child
Colleges & universities
Diagnosis
Esophageal diseases
Esophageal Perforation - diagnosis
Esophageal Perforation - etiology
Esophageal Perforation - therapy
Female
Foreign Bodies - complications
Fruit juices
Health sciences
Humans
Male
Medical diagnosis
Mortality
Ostomy
Pain
Risk factors
Sepsis
Suicide, Attempted
Tanzania
University colleges
Young Adult
Tanzania
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Summary:Oesophageal perforation is a condition associated with a high mortality. Its management is still controversial with operative treatment being favoured but a shift to conservative management is occurring. Very little exists in medical literature about its management in Sub-Saharan Africa, where the paucity of thoracic surgeons is compounded by limited diagnostic and therapeutic facilities. We report three cases of oesophageal perforation which were all treated conservatively with tube thoracostomy, nil by mouth with feeding gastrostomy, intravenous antibiotics and chest physiotherapy. Two patients achieved oesophageal healing but one died due to severe septicaemia. In a resource restricted setting, conservative management which includes enteral nutrition by feeding gastrostomy, tube thoracostomy to drain inter pleural contaminants, intravenous antibiotics and chest physiotherapy is a safe and effective treatment for oesophageal perforations.
ISSN:1749-8090
1749-8090
DOI:10.1186/1749-8090-6-116