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Eur J Cardiothorac Surg 2005;27:356
© 2005 Elsevier Science NL

Letter to the Editor

Reply to Muir and Graham

Jacques Jougon*, Gilbert Dubois

Department of Thoracic Surgery, Haut-Lévêque Hospital and University Victor Ségalen Bordeaux 2, avenue de Magellan, 33604 Pessac, France

Received 20 October 2004; accepted 25 October 2004.

* Corresponding author. Tel.: +33 5576 56009; fax: +33 5576 56021. (E-mail: jacques.jougon{at}chu-bordeaux.fr).

Key Words: Boerhaave's syndrome • Mediastinitis • Esophageal rupture • Empyema • Esophageal perforation

We agree with Dr Andrew D. Muir and Alastair Graham that the cornerstone of management of oesophageal perforation is prompt diagnosis. We also agree with them that resuscitation measures as they describe must be the management before referring the patient to a thoracic surgery department. However, the main message to give is that oesophageal perforation is a surgical emergency. Mediastinal and pleural lavage with debridment of necrotic tissue is the main treatment of pleural and mediastinal abscess and one of the main aims of resuscitation is to allow the patient to undergo that surgical treatment as soon as possible [1].

References

  1. Jougon J, Mc Bride T, Delcambre F, Minniti A, Velly JF. Primary esophageal repair for Boerhaave's syndrome whatever the free interval between perforation and treatment. Eur J Cardiothorac Surg 2004;25:475-479.[Abstract/Free Full Text]




This Article
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Right arrow Articles by Dubois, G.
Related Collections
Right arrow Mediastinum
Right arrow Pleura
Right arrow Esophagus - cancer
Right arrow Esophagus - other

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