FIVE CASES OF SPONTANEOUS ESOPHAGEAL RUPTURE

Abstract

We report five cases of spontaneous esophageal rupture treated at the hospital from 1995 to 2002. Primary closure was carried out in all five cases including one case added fundic patch. Surgery was carried out within 6 hours after rupture in two cases, in which leakage did not occur. Leakage of the sutured site was seen in another two cases, in which operation was performed over 15 hours after the perforation. One patient died of serious mediastinitis. One patient who was added fundic patch to primary closure to prevent anastomotic leakage was discharged well despite a delayed surgical treatment, 15 hours after the onset, and corrosion of the mediastinum due to repeated vomiting. We think that some means to prevent anastomotic leakage must be considered to patients at a high risk of developing leakage. The paper also presents an analysis of a total of 98 cases of spontaneous esophageal rupture reported in the Japanese literature from 1990 till 2002.