Esophageal perforation is a critical and potentially life-threatening event with considerable morbidity and mortality. The management tends to be controversial and it requires a thoughtful and individualized approach. Dr. J. David Richardson and Dr. Roxie Albrecht join us for an in depth discussion of challenging esophageal injuries including areas of debate such as the management of injuries recognized late, the preferred methods of surgical repair and buttress as well as the role of exclusion and cervical esophagostomy for diversion.ReferenceWestern Trauma Association Critical Decisions in Trauma: Diagnosis and management of esophageal injuries J Trauma Acute Care Surg. 2015 Dec;79(6):1089-95. PMID:26680145