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Medal-premium 1

A 54 yo alcoholic man presents to the emergency department with severe substernal and epigastric pain after vomiting while drinking alcohol earlier in the evening. Gastrografin esophagogram shows perforation of distal esophagus with drainage into the mediastinum. What is the most appropriate treatment?

Select one of the following:

  • Nonoperative management with total parenteral nutrition (TPN) and nasogastric decompression

  • Emergent primary repair

  • Esophagectomy and delayed reconstruction with interposition graft

  • Esophagostomy and placement of a feeding jejunostomy tube

Quiz by , created about 4 years ago

Quiz on Questions, created by tarheeldoc on 27/05/2013.

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Created by tarheeldoc about 4 years ago