[Spontaneous rupture of the esophagus (author's transl)]

Spontaneous rupture of the esophagus is a rare occurrence. Etiologically, a rise in pressure in the gullet far above the physiological extent is prominent with the result that the wall of the esophagus bursts in the distal third. Usually an enormous meal has been taken previously, with large amounts of alcohol. Repeated severe vomiting, often accompanied by diarrhea, may give rise to increased pressure in the distal esophagus which triggers the bursting mechanism. With one of our patients as an example, after a short description of the diagnosis the early indication for operation is seen to be decisive. The surgical method of choice is the over-suture of the rupture site and thoracic drainage. In contrast to spontaneous rupture of the esophagus, instrumental perforations of this organ are usually treated conservatively.