Abstract
A 18-year (1983-2001) retrospective review revealed 13 cases of spontaneous esophageal rupture (Boerhaave's syndrome) including 2 of cardiopulmonary arrest (CPA). Vomiting preceded the rupture in most patients. Chief symptoms were abdominal or chest. All were sent to our hospital after visiting a nearby hospital. The rate of correct diagnosis at the first hospital was 15.4%. Although the mean time from onset to the first visit was 1.3 hour, the mean time from onset to treatment was 25.3 hours. Delayed diagnosis and treatment are obvious. Pneumomediastinum, pleural effusion, and pneumothorax in chest radiography and chest computed tomography (CT) on admission were helpful in diagnosis. Esophagography and esophagoscopy were used to confirm esophageal rupture. Ten patients undergoing emergency surgery and 1 conservative therapy survived. The 2 CPA patients died due to tension pyopneumothorax. Early diagnosis and treatment are therefore important in improving prognosis.
