Spontaneous esophageal perforation in an acute burn patient

Spontaneous perforation of the esophagus is an uncommon and catastrophic event accompanied by extremely high morbidity and mortality. In a burn patient, diagnosis may be delayed because of painful burns that may mask the underlying problem. Diagnosis is dependent on a high index of suspicion and by inclusion of this entity in the differential diagnosis of chest pain. The authors report on a 45-year-old male who developed a spontaneous perforation of the esophagus while hospitalized for treatment of an 11% total body surface area burn. Diagnosis and initiation of appropriate treatment resulted in salvage of this patient. The pathophysiology of this disease and a review of the literature are presented.