Definition of Esophageal perforation:

An esophageal perforation is a hole in the esophagus, the tube through which food passes from the mouth to the stomach.

Causes, incidence, and risk factors:

A perforation is a hole through which the contents of the esophagus can pass into the mediastinum, the surrounding area in the chest. This often results in infection of the mediastinum (mediastinitis).

The most common cause of an esophageal perforation is injury during a medical procedure. However, because flexible instruments are now used this rarely occurs.

The esophagus may also become perforated as the result of:

• A tumor
• Gastric reflux with ulceration
• Previous surgery on the esophagus
• Swallowing a foreign object or caustic chemicals, such as household cleaners, disk batteries, and battery acid
• Trauma or injury to the chest and esophagus
• Violent vomiting

Less common causes include injuries to the esophagus area (blunt trauma) and injury to the esophagus during an operation on another organ near the esophagus.