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Clinical Pediatrics, Vol. 44, No. 2, 131-134 (2005)
DOI: 10.1177/000992280504400204
© 2005 SAGE Publications

Conservative Approach to the Mediastinitis in Childhood Secondary to Esophageal Perforation

Suzi Demirbag, MD

Departments of Pediatric Surgery, Gulhane Military Medical Academy, Ankara, Turkey

Tugrul Tiryaki, MD

Diskapi Social Security Children Hospital, Ankara, Turkey

Cuneyt Atabek, MD

Departments of Pediatric Surgery, Gulhane Military Medical Academy, Ankara, Turkey

Ilhami Surer, MD

Departments of Pediatric Surgery, Gulhane Military Medical Academy, Ankara, Turkey

Haluk Ozturk, MD

Departments of Pediatric Surgery, Gulhane Military Medical Academy, Ankara, Turkey

Salih Cetinkursun, MD

Departments of Pediatric Surgery, Gulhane Military Medical Academy, Ankara, Turkey

The aim of this study was to evaluate the safety and efficacy of nonoperative treatment of esophageal perforation (EP) in children. Between 1999 and 2004, 13 episodes in 12 patients were evaluated. The treatment program consisted of broad-spectrum antibiotics, nasopharyngeal aspiration, parenteral and/or enteral nutrition by gastrostomy, and pleural effusion or mediastinal abscess drainage when required. Mean age of the patients was 3.75 ± 1.13 (range 3-7 years). Two patients (16.7%) were girls and 10 patients (83.3%) were boys. Chest pain was found 76.9% of all EP episodes (10 of 13 perforations), followed by dyspnea in 69.2% (9 of 13), vomiting in 46.1% (6 of 13), fever in 46.1% (6 of 13), and epigastric pain in 7.6% (1 of 13). No deaths occurred. In children, in contrast with the adults, EP can be treated safely by nonoperative methods.


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