Internal Perforation of the Hypopharynx andOesophagus Observed in Conjunction with Endoscopy or Swallowing of a Foreign Body, at the ENTClinic in Hradec Králové in 1946 - 1996

Overview

The authors evaluate in detail a group of 16 patients with internal perforations of thehypopharynx or oesophagus during a 51-year period. The cause of injury was endoscopic examina-tion; in 12 patients it was endoscopy on account of a foreign body in the deglutitive pathways. Intwo patients dilatation of a stenosis was performed and in the subsequent two diagnostic flexibleendoscopies. Injuries in the upper third of the oesophagus predominate (nine patients) overperforations in the lower third of the oesophagus (five patients) and in the piriform recess (twopatients).In the diagnosis a crucial part is played by examination of the passage of the deglutitive pathwaysby aquoeus contrast material which confirmed perforation of the deglutitive pathways in 13 pati-ents.Ten patients were treated conservatively and four by surgery. A total of five patients died incl. twowhere perforation of the deglutitive pathways was found only post mortem. The authors refer tocontemporary views in the literature regarding treatment of perforations of the deglutitive pathways.

Key words:
perforation injury, endoscopy, oesophagus, piriform recess, treatment.