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September 10, 1938


Author Affiliations


JAMA. 1938;111(11):998-1004. doi:10.1001/jama.1938.02790370018005

Mediastinitis due to perforation of the esophagus has been generally considered a fatal condition.

Quotations from three representative authorities will suffice to show the expected outcome of this accident: "Rupture or perforation of the esophagus results in a mediastinal infection, which is fatal" (Broyles1). "If, in consequence of such injury, the mediastinum or the pleura is opened, death from infection is almost certain to occur" (Torek2). "The occurrence of a perforation of the esophagus is in the vast majority of cases associated with fatal consequences" (Graham, Singer and Ballon3).

Unfortunately these statements are true, but needlessly so. The work of Chevalier Jackson, Chevalier L.

Jackson, William Lerche,4 Herman Pearse Jr.5 and a few others shows that a great majority of patients can be saved by surgical intervention.

I desire to present my own series of twenty cases of mediastinal infection from esophageal perforation. There were