MANEJO DE LA PERFORACI 3N ESOF\uc1GICA. SERVICIO DE CIRUG\ucdA GENERAL. HOSPITAL CENTRAL UNIVERSITARIO DR. "ANTONIO MAR\ucdA PINEDA".

Con el objetivo de analizar el manejo de la perforacion esof\ue1gica en el Servicio de Cirug\ueda General del Hospital Central Universitario "Dr. Antonio Mar\ueda Pineda" durante el lapso 2008-primer semestre 2013, se realiz\uf3 un estudio descriptivo retrospectivo, en una serie de 45 pacientes cuyo promedio de edad fue 38,66 \ub1 15,61 a\uf1os, eran del sexo masculino (88,89%). La etiolog\ueda de la perforaci\uf3n del es\uf3fago fue 40% por traumatismo, 35,55% cuerpo extra\uf1o (62,5% pr\uf3tesis dental) y 15,55% causas quir\ufargicas (28,57%). Adem\ue1s, 80% la localizaci\uf3n fue en es\uf3fago cervical debido a cuerpo extra\uf1o (41,66%). Los principales s\uedntomas fueron disfagia (34,15%), herida en cuello (29,26%), dolor en cuello (26,82%), disnea (24,39%), dolor tor\ue1cico (21,95%) y odinofagia (28,12%). El m\ue9todo de diagn\uf3stico fue la endoscopia digestiva (56,25%) y el esofagograma (28,12%); tratamiento quir\ufargico recibido fue 44,44% esofagorrafia y drenaje, 42,22% esofagorrafia con colocaci\uf3n de flap muscular y drenaje; 44,44% requiri\uf3 entre 1 y 7 d\uedas para ser intervenido luego de producirse la perforaci\uf3n y 42,22% lo hicieron en menos de 24 horas. Present\uf3 complicaciones 37,78%. La mortalidad fue del 13,33% cuya perforaci\uf3n estaba localizada en el es\uf3fago tor\ue1cico (66,67%) y la principal t\ue9cnica quir\ufargica utilizada fue esofagorrafia + drenaje (50%). Asimismo, 26,66% fueron re-intervenidos por dehiscencia de esofagorrafia (50%) y absceso de cuello (25%). El per\uedodo de estancia hospitalaria predominante fue entre 8 y 30 d\uedas. En consecuencia, este estudio ofrece un aporte en la actualizaci\uf3n de las pautas o gu\uedas del manejo de urgencia de los pacientes con perforaci\uf3n de es\uf3fago. PALABRAS CLAVES DEL AUTOR: Perforaci\uf3n de es\uf3fago. Manejo m\ue9dico-quir\ufargico. Etiolog\ueda. Complicaciones. T\ue9cnicas quir\ufargicas ABSTRACT MANAGEMENT OF ESOPHAGEAL PERFORATION. GENERAL SURGERY SERVICE. HOSPITAL CENTRAL UNIVERSITARIO DR ANTONIO MARIA PINEDA In order to analyze the handling of esophageal perforation at the general surgery service of the Hospital Central University Dr Antonio Maria Pineda, during the 2008-first trimester 2013 time period, a retrospective descriptive study was conducted, the sample was comprised by 45 patients predominantly male (88.89%) with a mean age of 38.66\ub115.61 years. The etiology of esophageal perforation was 40% by trauma, 35.55% foreign body (62.5% denture) and 15.55% causes surgical (28.57%). In addition, 80% was in cervical esophagus location due to foreign body (41.66%). Main symptoms were dysphagia (34.15%), wound in neck (29.26%), pain in neck (26.82%), dyspnea (24.39%), chest pain (21.95%) and odynophagia (21.95%), being the method of diagnostic digestive endoscopy (56.25%) and the esophagogram (28.12%). Received surgical treatment was 44.44% esophagorraphy and drainage and 42.22% esophagorraphy with placement of muscle flap and drainage. Also 44.44% required between 1 and 7 days prior to surgery after perforation and 42.22% received surgery within 24 hours. Only 37.78% presented complications. Mortality was 13.33% whose perforation was located in the thoracic esophagus (66.67%) and the main surgical technique used was esophagorraphy+ drainage (50%). Likewise, 26.66% were re-intervened for esophagorraphy dehiscence (50%) and neck abscess (25%). The predominant hospital stay was between 8 and 30 days. Consequently, this study offers a contribution to update the guidelines or the management guidelines of urgency of patients with perforated esophagus. KEY WORDS: Perforation of esophagus. Surgical management. Etiology. Complications.