SURGICAL REPAIR OF ESOPHAGEAL-PERFORATION IN CIRRHOTIC-PATIENTS WITH VARICES

A 51-year-old woman, a known alcohol abuser, had sclerotherapy for eso phageal varices from portal hypertension. A perforation of the distal esophagus, diagnosed several days later, could not be closed primarily at thoracotomy due to extensive bleeding, The method of ''exclusion a nd diversion in continuity'' was modified by ligation of the esophagog astric junction with absorbable suture over a tube stent. The perforat ion healed and patency of the esophageal lumen was demonstrated 2 week s later. This alternative life-saving procedure may be useful in chron ic esophageal perforation, especially in cirrhotic or otherwise debili tated patients.