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Warning-sign checks

Esophageal perforation: when to get help

Go through these in order and stop at the first one that applies. If you are reading this for someone else, answer for them.

  1. 1

    Is any of this happening now?

    Call 911

    Get emergency medical help now for sudden severe chest, neck, back, or upper abdominal pain, especially after forceful vomiting, an endoscopy, an injury, or swallowing an object.

    New breathlessness, fever, rapid worsening, faintness, confusion, neck swelling, or crackling under the skin also requires emergency assessment.

    Do not eat or drink while waiting for emergency assessment if a perforation is suspected.

    Do not make yourself vomit or try to remove a swallowed object yourself.

    Other emergency signs, for anyone
    • Someone who is struggling to breathe, gasping, choking, or cannot get words out
    • Someone who has chest pain, tightness or pressure lasting more than a few minutes
    • Someone who has sudden weakness or drooping on one side of the face or body, slurred speech, or sudden confusion
    • Someone who is unconscious, or cannot be woken
    • Someone who is bleeding heavily and it will not stop with firm pressure
    • Someone who has had a seizure that will not stop, or does not wake up afterwards
    • Someone who has lips or skin that look pale, blue, grey or blotchy
    • Someone who you believe has taken an overdose or swallowed something poisonous
  2. 2

    Is any of this happening?

    Be seen today

    During recovery, seek urgent help for increasing pain, fever, shortness of breath, repeated vomiting, new swelling, inability to swallow saliva, or fluid leaking from a wound or drain.

  3. 3

    Does any of this apply?

    Book an appointment

    Routine follow-up can address gradually improving swallowing discomfort, diet changes, feeding-tube care, or returning to work and exercise.

    Keep appointments even if you feel better because imaging or stent removal may still be needed.

Every sign above is quoted from the sofidex article on Esophageal perforation. If you are not sure, err upward — it is always reasonable to be checked.