Oesophageal injury

Oesophageal injuries are rare, the majority being iatrogenic, spontaneous (Boerhaave's syndrome) or caustic. Partial-thickness injuries are usually not serious, and heal, but, due to its location, full-thickness injuries of the oesophagus can have catastrophic consequences, leading to significant morbidity and sometimes death. Effective early treatment in experienced centres can lead to successful outcomes, although this relies on a low index of suspicion and rapid clinical recognition of this uncommon problem. Discussion with a specialist centre is mandatory, and it is usually appropriate to transfer the patient to such a centre. Computed tomography scan, contrast swallow and selective use of endoscopy by an experienced endoscopist are the investigations of choice, and a multidisciplinary approach to the management involving interventional radiology, interventional endoscopy and surgery will lead to the best outcomes.