Are Stents Good Enough for Routine Initial Therapy of Esophageal Perforation?

Spontaneous esophageal perforation is a rare diagnosis with poor prognosis. Treatment strategies include conservative management, endoscopic therapy, and operative management. There is no definitive treatment algorithm for spontaneous esophageal perforation and management is determined based on individual patient and disease characteristics. While prompt operative intervention is recommended for patients with hemodynamic instability or widespread contamination, patients with less severe disease can be managed more conservatively. Endoscopic stent placement and surgical repair are often utilized as methods of primary intervention. In this review we determined that esophageal stenting can be used to treat spontaneous esophageal perforation in carefully selected patients who are hemodynamically stable.