Spontaneous Perforation of the Esophagus

¹ Fellow in Medicine, Mayo Foundation.
² Section of Surgery

Spontaneous rupture of the esophagus is a rare catastrophe that is usually secondary to violent retching and vomiting. Esophagitis is probably a precipitating factor. The development of the lesion is characterized by the sudden onset of severe epigastric, retrosternal or thoracic pam, which is followed by dyspnea, cyanosis and shock. Examination discloses evidence of pleural effusion or hydropneuxnothorax in most instances. The development of subcutaneous emphysema in the neck is an important diagnostic feature. Roentgenologic findings are characteristic and usually confirm the diagnosis. The most important factor in reaching an early diagnosis is the awareness of the possibility of the lesion having occurred. Surgical intervention is most successful when done early in the course of the illness.