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  • Esophageal Disease

    The fellow should be able to:

    • Demonstrate an understanding of the management of esophageal perforation and rupture
    • Describe the surgical technique for esophageal perforation and the difference between acute vs delayed presentation
    • Understand the role of esophageal stenting, direct repair and endoluminal wound VAC therapy
    • Demonstrate an understanding of the management of caustic ingestions
    • Describe the differences between acid and alkali ingestion
    • Discuss the role of endoscopy in the setting of caustic ingestion

    Resources

    • Topic Summary
    • AAST Education Module - Esophageal Perforation
    • AAST Education Module - Caustic Ingestion
    • Overview Article:
      • Fairbairn K, Worrell SG. Esophageal Perforation: Is Surgery Still Necessary? Thorac Surg Clin. 2023 May;33(2):117-123. doi: 10.1016/j.thorsurg.2023.01.005. Epub 2023 Feb 26. PMID: 37045480.
    • Additional Resources:
      • Owen RP, Chidambaram S, Griffiths EA, Sultan J, Phillips AW, Vohra R, Preston S, Gossage J, Hanna GB, Underwood TJ, Maynard N, Markar SR; MUSOIC study group. Multicenter, Prospective Cohort Study of Oesophageal Injuries and Related Clinical Outcomes (MUSOIC study). Ann Surg. 2023 Dec 1;278(6):910-917. doi:
      • Esophageal stenting: van Halsema EE, Kappelle WFW, Weusten BLAM, Lindeboom R, van Berge Henegouwen MI, Fockens P, Vleggaar FP, Spaander MCW, van Hooft JE. Stent placement for benign esophageal leaks, perforations, and fistulae: a clinical prediction rule for successful leakage control. Endoscopy. 2018 Feb;50(2):98-108. doi: 10.1055/s-0043-118591. Epub 2017 Sep 21. PMID: 28934822.
      • Chirica M, Kelly MD, Siboni S, Aiolfi A, Riva CG, Asti E, Ferrari D, Leppäniemi A, Ten Broek RPG, Brichon PY, Kluger Y, Fraga GP, Frey G, Andreollo NA, Coccolini F, Frattini C, Moore EE, Chiara O, Di Saverio S, Sartelli M, Weber D, Ansaloni L, Biffl W, Corte H, Wani I, Baiocchi G, Cattan P, Catena F, Bonavina L. Esophageal emergencies: WSES guidelines. World J Emerg Surg. 2019 May 31;14:26. doi: 10.1186/s13017-019-0245-2. PMID: 31164915; PMCID: PMC6544956.
      • Hoffman RS, Burns MM, Gosselin S. Ingestion of Caustic Substances. N Engl J Med. 2020 Apr 30;382(18):1739-1748. doi: 10.1056/NEJMra1810769. PMID: 32348645.
      • Abbas G, Schuchert MJ, Pettiford BL, Pennathur A, Landreneau J, Landreneau J, Luketich JD, Landreneau RJ. Contemporaneous management of esophageal perforation. Surgery. 2009 Oct;146(4):749-55; discussion 755-6. doi: 10.1016/j.surg.2009.06.058. PMID: 19789035.

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