Abstract
The incidence of esophageal perforations is on the rise, and iatrogenic causes remain the most common and continue to increase in an era of frequent use of endoscopy for diagnostic and therapeutic procedures. Despite many advances in care, the mortality rate for an esophageal perforation remains high, with some series citing 20%. The esophagus passes through the neck, chest and abdomen, so surgeons managing perforations must be experienced with the unique anatomic considerations for approaching a perforation in any of these levels/locations. Many factors must be considered when managing these patients, including acuity of presentation, contamination, size of leak, cause of leak, and comorbid conditions. Those caring for esophageal perforation must be experienced in endoscopic procedures, esophageal resection, and complex esophageal reconstruction. © 2019 Elsevier Inc. All rights reserved.