Table 1.

Management options for oesophageal perforation

Clinical picture	Management	Reference
Delayed presentation with minimal or no sepsis	Non-operative Monitor in high care facility Resuscitation I/V antibiotics Parenteral or jejunal nutrition	23
Small perforation	Tissue buttressing Mediastinal debridement I/V antibiotics Parenteral or jejunal nutrition	6,24,25,26,27
Large perforation	Oesophageal T tube Mediastinal debridement I/V antibiotics Parenteral or jejunal nutrition	24
Large perforation and extensive contamination	Cervical oesophagostomy Decompressive gastrostomy Gastro-oesophageal stapling Feeding jejunostomy I/V antibiotics	24,28
Perforation with pre-existing oesophageal disease or severely damaged oesophagus	Oesophagectomy	28