Abstract
We report a case of spontaneous esophageal rupture in an elderly woman saved by two–stage surgery over 72 hours after onset.
A 74–year–old woman seen as an emergency outpatient for persistent right chest pain and respiratory discomfort from the day before was diagnosed with aggravated chronic bronchitis and sent home. She went into shock the following day, however, requiring emergency hospitalization. The diagnosis of spontaneous intrathoracic esophageal rupture requiring surgery was based on imaging. Two–stage surgery was conducted when the primary suture could not close the rupture. The first surgery involved subtotal thoracic esophagectomy, external esophagostomy, enterostomy, and thoracic cavity and posterior mediastinum drainage. She developed intractable methicillin–resistant Staphylococcus aureus–induced pneumonia postoperatively but surrived. On hospital day (HOD) 122, the second surgery comprised antethoracic cervical esophagogastric anastomosis. Her postoperative course was satisfactory, and she was discharged improved on HOD 152. She remains well 12 months after surgery.
