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Spontaneous midesophageal rupture

H Y Kaplan, S Katz, E B Chetrit

    Israel Journal of Medical Sciences
    |September 1, 1980
    PubMed
    Summary
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    Spontaneous esophageal rupture is a rare condition. This case highlights successful surgical drainage and irrigation for a patient who experienced rupture during sleep, leading to recovery after prolonged hospitalization.

    Area of Science:

    • Gastroenterology
    • Thoracic Surgery
    • Medical Case Reports

    Background:

    • Spontaneous esophageal rupture is an uncommon and potentially life-threatening condition.
    • True spontaneous esophageal perforation, distinct from Boerhaave syndrome, is exceedingly rare.

    Observation:

    • A case of true spontaneous esophageal rupture occurred in a patient during sleep.
    • Diagnosis was delayed by 36 hours post-rupture.
    • Treatment involved extrapleural surgical drainage via a posterior mediastinal approach and repeated irrigation of a paraesophageal abscess.

    Findings:

    • The extrapleural drainage successfully avoided empyema.
    • The patient required a 56-day hospitalization for recovery.
    • Povidone-iodine solution was effective for abscess irrigation.

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    Implications:

    • This case underscores the importance of timely diagnosis and appropriate surgical management for spontaneous esophageal perforation.
    • The presented therapeutic approach offers a viable option for managing paraesophageal abscesses.
    • Further research into the pathogenesis of true spontaneous esophageal perforation is warranted.