Injury to the esophagus is rare. Foods and liquids pass through the esophagus from the mouth and into the stomach. The esophagus is designed to be a very strong organ and is virtually impervious. Though, if there is an injury, it has to be detected and treated early with surgical intervention. If untreated can lead to serious conditions and complications. Since the esophagus connects from the mouth and into the stomach, it is quite long and thereby for medical clarity has been divided into three parts: cervical – inside the neck, thoracic – inside the chest and abdominal – inside the stomach area.
Causes Of Esophageal perforation
Some of the common causes of esophageal injury and perforation are outlined as follows:
- Ingestion of a sharp object: Lacerations, tissue destructions, penetrating injury and iatrogenic injury can be formed on the esophagus as the object is swallowed.
- Forceful vomiting: Extreme pressure is induced during vomiting which can cause rupture of the esophagus
- Ingestion of harmful chemicals: Intake of abrasive, alkaline or acidic chemicals and drugs can harm the esophagus
- GERD: Gastroesophageal reflux disease causes gradual backflow of acid into the stomach and form ulcers in the throat
- Physical trauma: When there is direct injury to the throat due to an accident
Esophageal Perforation Symptoms
Injury to the esophagus can happen in any of the three parts of the esophagus. Patient with injury to esophagus usually feels pain in the area where the injury has occurred. Patients also show a variety of symptoms:
- Severe chest pain under the breast bone with vomiting sometimes associated with fainting
- Dyspnea, rapid and shallow breathing
- Subcutaneous emphysema when air gets beneath the layer of the skin particularly in the area of the chest and neck
- Unrestrained sweating
- High fever
- Retching and vomiting sometimes with blood
- Rapid heart rates
- Dysphagia or difficulty in swallowing
- Hypotension or low blood pressure
Diagnosis Of Esophageal Perforation
CT Scan :A chest CT scan may be conducted to diagnose cancer or ulcer in the esophagus
Chest X-ray: This is a Gastrografin swallow esophagogram where the patient swallows a contrast material to determine the area or site of rupture and injury to the esophagus.
Flex esophagoscopy :This test is done to determine the expanse of injury and perforation whether transmural or mucosal, to the esophagus.