AB151. SOH21AS111. Management of iatrogenic oesophageal perforation: a case report

Background: Sixty percent of oesophageal perforations are iatrogenic. Oesophageal perforation may cause mediastinitis and sepsis, with a 10–20% mortality rate. Prompt treatment improves survival. The Pittsburgh Perforation Severity Score (PSS) guides treatment and stratified patients into low (≤2), intermediate (3–5) and high risk (>5). Treatment is guided by the PSS score. Options include; conservative management, incorporating broad spectrum antimicrobial cover, feeding adjuncts and endoscopic interventions. For high risk cases, surgical debridement and repair may be undertaken, with emergency oesophagostomy reserved for severe cases. The aim of this report is to use a case study to discuss management strategies.