[Spontaneous Esophageal Rupture Diagnosed as Pneumothorax at First:Report of a Case]

We experienced a case of idiopathic esophageal rupture, which can easily become severe. The patient was a 63-year-old man. At the initial visit, he was diagnosed with pneumothorax, but computed tomography(CT) showed mediastinal emphysema and esophagography showed perforation, which led to the diagnosis of the above disease. Surgery was performed more than 24 hours after the initial diagnosis. The perforation was closed with sutures and covered with mediastinal pleura. An enterostomy was added at the same time. Postoperatively, pneumonia and pleural effusion were observed, but the patient was discharged from the hospital without serious complications due to systemic management including measures against sepsis and respiratory complications and nutritional management. In the postoperative management of this disease, it is important to pay attention to systemic management such as nutritional management as well as countermeasures against infection and respiratory complications.