article · Zenodo (CERN European Organization for Nuclear Research)
Esophageal perforation following caustic ingestion is a life-threatening emergency classically managed by surgery. We report the case of a 46-year-old male admitted after intentional ingestion of 300 mL of hydrochloric acid, presenting with hematemesis and dyspnea. CT scan revealed a 3.15 mm distal esophageal perforation with hydropneumothorax and no mediastinal collection. The patient was hemodynamically stable without signs of sepsis. Based on non-operative criteria and a Pittsburgh Perforation Severity Score of 1, conservative management was initiated: strict fasting, enteral nutrition via feeding jejunostomy, broad-spectrum antibiotics, and proton pump inhibitors. The outcome was favorable with oral refeeding resumed on Day 7. This case highlights that surgery can be avoided in carefully selected patients with caustic esophageal perforation.
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DOI: 10.5281/zenodo.20075679
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