Abstract
Spontaneous esophageal rupture is rare in old age. We treated such a rupture successfully managed by suturing of the ruptured site and reinforcement by pedicled omental covering. A 75-year-old man seen by local physician reported vomiting, followed by chest pain, dyspnea, and abdominal pain after an episode of drinking. No signs of abnormality were seen in electrocardiography or echocardiography, so he was referred to our hospital with suspected acute abdomen. Upper gastrointestinal scopy showed rupture in the lower esophagus. Under a diagnosis of spontaneous esophageal rupture, we conducted emergency surgery 21 hours after symptom onset. After thoracotomy and laparotomy with an incision of the diaphragm, the esophageal rupture was sutured and the site reinforced with a pedicled omental covering to prevent suture failure. No suture failure or stenosis of the sutured site was seen postoperatively. The man was discharged 23 days after surgery. For spontaneous esophageal rupture, we found the pedicled omental covering procedure useful for reinforcing sutures.
