Recurrent spontaneous esophageal rupture

Abstract

Spontaneous rupture of the esophagus is a relatively uncommon event, and recurrent rupture is extremely rare. We present a patient who experienced and survived 2 spontaneous perforations of the esophagus, occurring 6 years apart. A 43-year-old man was admitted to our hospital with upper abdominal pain after vomiting. Esophagoscopy, esophagogram, and computed tomography were suggestive of esophageal rupture. Emergency left thoracolaparotomy revealed a 20-mm perforation of the left lower esophageal wall that had been previously repaired. After the perforation was repaired with a single-layer closure, the mediastinum and pleural cavity were drained. The patient recovered well and was discharged from the hospital on postoperative day 29. To the best of our knowledge, only 7 previous cases of recurrent spontaneous esophageal perforation have been reported in the literature.

Two-tube method for treatment of spontaneous esophageal rupture and concomitant mediastinal infection

“…The incidence is approximately 0.02%, but the mortality rate ranges from 10% to as high as 60%. 3 – 5 , 8 It is a life-threatening condition characterized by disruption of the distal esophagus due to barotrauma, resulting in contamination of the mediastinum and pleural cavity with gastric contents. Therefore, early recognition and prompt drainage of the leakage is of paramount importance.…”

“…Spontaneous esophageal rupture (SER) is a rare but catastrophic condition with high mortality. 1 – 3 Current treatment options include conservative treatment, surgical intervention, endoscopic stent placement, thoracic closed drainage, and the traditional “three-tube” method (jejunal feeding tube, gastrointestinal decompression tube, and thoracic closed drainage tube). However, the most effective and feasible treatment option for SER remains controversial, and no standardized treatment algorithm has been established.…”

Recurrent, Spontaneous Esophageal Ruptures Associated With Antiphospholipid Antibody Syndrome: Report of a Case

“…Recurrent ruptures of the esophagus are extremely rare, with only 8 cases, including the present case, being reported in the English literature. [2][3][4][5][6][7] One case involved a 17-year-old female patient, and the remainder of the cases involved male patients ranging in age from 45 to 66 years. In one of these cases, the rupture occurred at the level of the midesophagus, whereas the other 7 patients experienced perforations of the lower esophagus.…”

“…Further, recurrence of the syndrome is extremely rare, with only 7 cases having been reported in the English literature. [2][3][4][5][6][7] In addition, the pathophysiologic mechanisms responsible for Boerhaave syndrome have not been clearly determined.…”

Successful stenting of four spontaneous oesophageal perforations in a single patient during a 3-year period

“…To date, only eight cases of recurrent oesophageal perforations, occurring up to 30 years after the first perforation, have been published [ 6 ]. The majority of these patients were treated by surgical repair through a thoracotomy at the initial episode, as well as at the recurrent perforation, although, supportive care was used in a few.…”