DefinitionAn esophageal perforation is a hole in the esophagus, the tube through which food passes from the mouth to the stomach.Alternative NamesPerforation of the esophagusCauses, incidence, and risk factorsA perforation is a hole through which the contents of the esophagus can pass into the mediastinum, the surrounding area in the chest. This often results in infection of the mediastinum (mediastinitis).The most common cause of an esophageal perforation is injury during a medical procedure such as esophagoscopy. However, because flexible instruments are now used this rarely occurs.The esophagus may also become perforated as the result of:A tumorGastric refluxwith ulcerationSwallowing a foreign object or caustic chemicalsViolent vomitingLess common causes include injuries to the esophagu