Hot potato causing full-thickness esophageal burn and perforation: a case report

Background: Esophageal perforation is a heterogeneous clinical entity. The common denominator is mediastinal contamination by digestive contents possibly evolving to sepsis, multiorgan failure, and death if not timely and appropriately treated. Mortality ranges between 10% and 20% while delay in treatment (>24 hours) has been shown to be a valuable inverse survival predictor. Non-operative management (NOM) and endoscopic treatment may be considered in stable patients with early presentation, limited esophageal disruption, and contained contamination. On the contrary, surgery should be considered in patients who do not meet NOM criteria. General principles of surgical management include exposure, debridement of non-viable tissue, tension-free defect closure, suture buttressing, and drainage. Esophageal exclusion, diversion, or resection should be considered when primary repair is not feasible.