A CASE OF SPONTANEOUS RUPTURE OF THE ESOPHAGUS

Abstract

We report on a case of spontaneous rupture of the esophagus which responded to the conservative treatment although it took 1 week untill a definite diagnosis was made. It is described with some discussion of the literature.
The patient was a 53-year-old male. Vomting after drinking alcohol was followed by the appearance of sudden left presternal pain, precordial pain, and dyspnea. The patient was admitted to a hospital where chest X-ray on the next day revealed a large left pleural effusion. Drainage of this effusion could yield no symptomatic remission, and 7 days later food desidue was noted in the liquid from the chest tube. Fluoroscopy of the esophagus revealed a leakage of gastrographin from the left side of the lower esophagus. Spontaneous rupture of the eophgus was diagnosed, and the patient was admitted to our clinic. Two new thoracic cavity drains were inserted and gastric fistulotomy was performed. The patient responded to control of the intrathoracic contamination and central venous nutrition, and his life could be saved.