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Treatment

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

The important features are:

  • prompt recognition
  • nil by mouth until at least the fifth day after diagnosis; oral feeding is withheld until a contrast swallow confirms healing at this stage
  • pleural space drained
  • hyperalimentation with hypertonic glucose and amino acids; this allows infection to be more readily controlled and encourages wound healing
  • antibiotics e.g. combination of intravenous gentamicin, cefuroxime and metronidazole
  • fluid resuscitation
  • surgical repair if recognised early. If there is a late presentation then surgical drainage and diversion may be needed.

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