Learning Objectives:

1.The location, timing, and degree of perforation dictate management and therapeutic options.

2. The vast majority of esophageal perforations are iatrogenic and usually related to endoscopy. The most common site of injury is in the neck at the cricopharyngeus muscle.

3.When the injury occurs during endoscopy for esophageal dilatation, the most common site of perforation is at the stricture of the original disease.