Treatment of Esophageal Perforation Amenable to Salvage of the Native Esophagus

This protocol addresses esophageal perforation in patients where salvage of the native esophagus is feasible. The spectrum includes small, contained perforations as well as frank perforations extending into the mediastinum or pleural space.

Frank perforation into the mediastinum or pleural space requires endoscopic or operative intervention. Advances in endoscopic technologies over the past two decades have made native esophagus salvage possible across a range of perforation severities, guiding a shift toward organ-preserving approaches.

Management centers on endoscopic salvage of the native esophagus combined with drainage of any associated effusion. The specific closure strategy applied — and the conditions under which each option is selected — are detailed in the full structured protocol.