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2010, Number 1

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Rev Mex Cir Pediatr 2010; 17 (1)

Management of perforations and esophageal anastomotic leaks in pediatrics

Aguilar-Cota J, Jiménez-Urueta PL, Alvarado-Garcia R, Sanchez- Michaca V, Castañeda ORA
Full text How to cite this article

Language: Spanish
References: 10
Page: 6-10
PDF size: 824.59 Kb.


Key words:

Oesophageal perforation, conservative management, complications.

ABSTRACT

Introduction: Esophageal injury caused by surgery, has a morbi-mortality , because of its characteristics and behavior in the thorax it increases the risk of severe complications as mediastinitis and sepsis. Our presented experience of esopghageal injury caused for surgery, endoscopic.
Materials and methods: A retrospective study , clinical y analytic study from Jenuary l987 a Jenuary 2009 was done in patients with esophageal injury. Injury mechanism, site of de injury, radiologic, endoscopic studies , and actual status of the patients were analized.
Results: There were 16 males and 14 females . Eighteen operated for colonic interposition presented cervical fistula. One patiente with cervical fistula for venodisecction. In the torax, 9 patients with perforation o fistula . Two patient with injury abdominal esofagus.
Discusión: The Frecuency of esophageal perforation in children is low, A conservative tretment must be used in the most of the cases in children. The current tendency is towards a non surgical conservative treatment.
The surgical treatment Is indicated in injury abdominal esofagus.


REFERENCES

  1. 1.- Wesdorp IC, Bartelsman JF. Treatment of instrumental oesophageal perforation. Gut 1984;5;398-404.

  2. 2.- Santos GH. Frater EW. Transesophageal irrigation for treatment of medistinitis produced by rupture. JThorac Cardiovasc Surg 1986;91:57-62.

  3. 3.- Mengoli LR, Klassen KP. Conservative Management of esophageal perforation. Arch Sur 1965;91:232-40.

  4. 4.- Alvarado GR, Jiménez UP, Avila ZM. Resultados de La sustitución esofágica por vía retroesternal en pacientes con atresia esofágica sin fístula, con y sin toracotomía previa. Cir Curuj 2002; 70: 322.-325

  5. 5.-Alvarado AR, Jiménez UP, Gallego GG, Sollano CL, Gutierrez CP.Interposición de colon retroesternal en niños. Analisis de 33 casos. Acta Pediatr Mex 2002;23(3): 139-143.

  6. 6.-Jiménez UP, Alvarado GR, Jorge GG, Alejandro GB. Tratamiento conservador de perforaciones y fugas anastomoticas del esófago intratoraxico.

  7. 7.- Michel L, Grillo HC. Operative and nonoperative management of contained intrathoracic esophagel disruptions. Ann Thorac Surg 1979;404-8.

  8. 8.- Jiménez UP, Casteñeda OR, Gutierrez EJ, Waller GA, Dominguez GE. Salvamento de esófago en el paciente pediátrico con estenosis secundaria a ingestión por causticos. Rev Mex Cir Ped 1999;6:44-46.

  9. 9.- Ajalat GM , Mulder DG. Esophageal perforations : the need for individualized approach. Arch Sur 1980; 119:1318-1320.

  10. Larrieu AJ, Kieffer R. Borhaave syndrome : report of a case treated nonoperatively. Ann Su 1975;181:57-63 Aguilar CJ, Jimenez UPS, Alvarado GR, Sanchez MV, Castañeda ORA




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Rev Mex Cir Pediatr. 2010;17