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Updated: May 7, 2026

Robotic Myotomy and Partial Fundoplication for Achalasia
Published on: August 11, 2023
Spontaneous perforation of the esophagus in a patient with achalasia
Andrew R Moriarity1, John O Larkin1, Katie E O'Sullivan1
1Department of Surgery, St. James's Hospital and Trinity Center for Health Sciences, Dublin, Ireland.
Abstract:
Esophageal perforation in achalasia is rare. The risk would mainly follow pneumatic dilatation, and spontaneous perforation has not been described. We report a case of spontaneous rupture of the midesophagus in a 56-year-old woman with treated achalasia in whom the perforation occurred during a meal and was not preceded by emesis. A gastrografin swallow confirmed extravasation of contrast medium from the esophagus, and endoscopy revealed significant esophageal food stasis, consistent with achalasia, with a large tear in the midesophagus and gross mediastinal contamination. She subsequently underwent a three-stage esophagectomy with an uneventful recovery.
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