A Patient in Whom Upper Endoscopy Was Useful for the Diagnosis of Esophageal Perforation Caused by Rupture of a Dissecting Aortic Aneurysm

Abstract

We describe a 59-year-old woman who coughed and vomited a small amount of blood on the day of presentation. Upper endoscopy was performed on the same day. The examination revealed only fibrin clot-like coagula in the esophagus. Contrast-enhanced computed tomography of the chest and abdomen was performed to locate the source of bleeding. The patient was given a diagnosis of dissecting aortic rupture and esophageal perforation.
A search of the database of the Japan Medical Abstracts Society for the period from 2001 through 2015 revealed only 23 reported cases of esophageal perforation associated with rupture of a dissecting aortic aneurysm as confirmed on upper endoscopy in Japan, including our patient. We describe our experience with this very rare case along with a discussion of the literature.