Unfortunately, in the present time, the most common cause of esophageal perforation is iatrogenic.

Endoscopy has no role in the diagnosis of spontaneous esophageal perforation.

While there is a success rate up to 90%, there are some potentially significant complications including aspiration and esophageal perforation.

Puncture of the wall of the esophagus (esophageal perforation).

In contrast, the term Boerhaave's syndrome is reserved for the 10% of esophageal perforations which occur due to vomiting.

With cervical esophageal perforations, plain films of the neck show air in the soft tissues of the prevertebral space.

Pain can occasionally radiate to the left shoulder, causing physicians to confuse an esophageal perforation with a myocardial infarction.

"Esophageal Perforation in a Sword Swallower."

An esophageal perforation was found and surgically repaired; 19 days later a leak at the site required a transhiatal esophagectomy with a left cervical esophagogastrostomy.

If esophageal perforation is suspected, even in the absence of physical findings, contrast radiographic studies of the esophagus and a CT scan should be obtained promptly.

Complications may also be severe and long-lasting or permanent, such as vocal cord damage, esophageal perforation and retropharyngeal abscess, bronchial intubation, or nerve injury.

The diagnosis of esophageal perforation could also be confirmed by water-soluble contrast esophagram (Gastrograffin), which reveals the location and extent of extravasation of contrast material.

Sometimes more significant complications occur including erosion of the nose where the tube is anchored, esophageal perforation, pulmonary aspiration, a collapsed lung, or intracranial placement of the tube.

The most common accompanying injury is esophageal perforation or rupture (known as Boerhaave syndrome), which occurs in as many as 43% of the penetrating injuries to the neck that cause tracheal injury.