What is the most common cause of perforation of the oesophagus?
 

A.	Barotrauma
B.	Mediastinitis
C.	Iatrogenic infection
D.	Malignancy

Show Answer

Correct Answer » C Explanation

Oesophageal perforation is a serious surgical emergency associated with:

• High morbidity
• Mediastinitis
• Sepsis
• Mortality if diagnosis is delayed

Most Common Cause

Iatrogenic injury — Correct Answer

The most common cause of oesophageal perforation is:

Instrumentation during medical procedures

Common causes include:

• Upper GI endoscopy
• Esophageal dilatation
• Nasogastric tube insertion
• Endotracheal intubation
• Transesophageal echocardiography (TEE)

Hence:

Iatrogenic perforation is the commonest cause overall.

Explanation of Other Options

A. Barotrauma

Barotrauma can cause:

• Spontaneous oesophageal rupture (Boerhaave syndrome)

This occurs after:

• Forceful vomiting
• Sudden rise in intraesophageal pressure

However, it is NOT the most common cause overall.

B. Mediastinitis

Mediastinitis is:

A complication of oesophageal perforation,

not a cause.

D. Malignancy

Esophageal cancers may rarely perforate:

• Spontaneously
• After radiotherapy
• During instrumentation

But malignancy is not the most common cause.