Abstract
Spontaneous esophageal rupture (Boerhaave syndrome) occurs rarely, and is thought to be a severe emergency disease that may be lead to mediastinitis and pyothorax, so that immediate diagnosis and treatment are important. A 51-year-old man with alcoholic cirrhosis, suffered chest pain and hematemesis followed vomiting after taking polyethylene glycols (PEG) for total colonoscopy at home. Chest computed tomography (CT) demonstrated emphysema in the area between the cervix and the lower mediastinum and left-sided pleural effusion. An upper gastrointestinal series confirmed medium leakage from the lower esophagus. Emergency operation was undertaken about 10 hours after the onset. Operative findings were bloody pleural effusion and rupture at the left-side of the lower esophagus 2 cm in length. The lacerated wound was sutured directly, and sufficient irrigation and drainage of the thoracic cavity were performed. Although he suffered from disseminated intravascular coagulation and endured four days of mechanical ventilation, the operative course was satisfactory. Because two cases of esophageal rupture after taking PEG has been reported in our country, slower administration of PEG and avoiding the use of PEG at home are thought to be important.
