What is Esophageal Perforation?

Jonathan Kiev, MD, is a Lexington, Kentucky-based cardiothoracic surgeon practicing medicine for over three decades. Since 2014, he has served as president of AOK Innovations, LLC, a company that designs and develops innovative medical devices. Some of Dr. Jonathan Kiev’s top areas of expertise are minimally invasive surgery, robotic surgery, and esophageal perforation.

Esophageal perforation occurs when there is a hole in the esophagus — the muscular tube that conveys food from the mouth to the stomach. A healthy esophagus protects the mediastinum (chest cavity) and abdomen from being exposed to swallowed materials (food). In esophageal perforation, food expulsion from the esophagus may occur in the neck, chest, or abdomen. Pain sometimes radiates from the perforated site, which usually causes difficulty swallowing.

Esophageal perforation can be caused by tumors in the throat, gastroesophageal reflux disease, violent vomiting (a condition called Boerhaave syndrome), accidental swallowing of dangerous chemicals or foreign objects, and physical trauma. The condition sometimes results in an accumulation of fluid in the chest cavity (mediastinum). Bacterial infection may develop and spread from the perforated site if not treated.