Difficult intubation, age older than 60 years, and female gender were associated with claims for perforation of the esophagus or pharynx.

There is risk of perforation of the esophagus with the use of dilators for treatment.

These include peptic strictures caused by esophageal reflux and perforations of the esophagus.

Patients with esophageal food boluses are also at risk of complications, such as perforation of the esophagus, and aspiration into the lungs.

X-rays are also useful for identifying the type of foreign body ingested and complications of foreign body ingestion, including mediastinitis and perforation of the esophagus.

Before the development of modern cardiovascular surgery, cases of acute mediastinitis usually arose from either perforation of the esophagus or from contiguous spread of odontogenic or retropharyngeal infections.

Spontaneous perforation of the esophagus most commonly results from a sudden increase in intraesophageal pressure combined with relatively negative intrathoracic pressure caused by straining or vomiting (effort rupture of the esophagus or Boerhaave's syndrome).

A minor injury may predispose the performer to sustaining a more major one; these more serious injuries include perforation of the esophagus, stomach, heart, lungs, and other organs in proximity to the path of the sword, as well as intestinal bleeding.

"Interestingly in this small study, perforation of the esophagus seemed to be associated with less severe problems than the same complication in patients undergoing endoscopy," said Dr. Brian Witcombe, the lead author of the paper and a consultant radiologist at Gloucestershire Royal Hospital in Gloucester, England.

Historical treatment of food bolus obstruction included administration of proteolytic enzymes (such as meat tenderizers), or even acidic substances, such as Coca-Cola with the purpose of degrading the meat that was blocked; however, it is possible that these methods may increase the risk of perforation of the esophagus.