Spontaneous rupture of the oesophagus. Avoidance of postoperative morbidity

Keighley, M. R. B.; Girdwood, R. W. A.; Ionescu, Marian I.; Wooler, G. H.

doi:10.1002/bjs.1800590818

Cited by 52 publications

(17 citation statements)

References 26 publications

(4 reference statements)

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“…The visible muscle split is usually shorter than the mucosal tear. Keighley and his colleagues showed that the muscle split was 2 cm shorter in the 7 cases in whom accurate measurements were taken (Keighley et al, 1972). Others have made the same observation.…”

Section: Resultsmentioning

confidence: 71%

“…Both posteroanterior and lateral views should be obtained. When the topic was reviewed by Toghill et al in 1968, air had never been shown below the diaphragms, but this has now been reported by Bruno et al (1963), Keighley et al (1972) and Thornley and Wallwork (1 978). Pneumopericardium was reported by Mansour and Teaford (1973) but the case they described had previously undergone oesophagogastrectomy for a benign stricture of the lower oesophagus and subsequent fundic patch oesophagoplasty for recurrent stricture, 14 months before final presentation with oesophageal rupture into the pericardium.…”

Section: Investigationsmentioning

confidence: 85%

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Rupture of the abdominal oesophagus: A review

Walsh¹

1979

British Journal of Surgery

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'Spontaneous' rupture of the oesophagus usually affects the lower third, less commonly the middle third and rarely the cervical oesophagus. Rupture limited to the intra-abdominal oesophagus is rare. Such a case is described here and previously reported cases are reviewed. Vomiting-induced gastro-oesophageal injuries and their aetiology are discussed and the management of spontaneous rupture is reviewed.

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Section: Resultsmentioning

confidence: 71%

Section: Investigationsmentioning

confidence: 85%

Rupture of the abdominal oesophagus: A review

Walsh¹

1979

British Journal of Surgery

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“…The symptoms can be easily misdiagnosed as dissecting aneurysm, myocardial infarction, pulmonary embolism, aspiration pneumonia, lung abscess, or ruptured subphrenic abscess (12). Keighley et al reported that the rate of diagnostic error is as high as 50% (13).…”

Section: Discussionmentioning

confidence: 99%

A Case of Rapid Diagnosis of Boerhaave Syndrome by Thoracic Drainage

Suzuki

Sato

Matsuda

et al. 2012

The Journal of Emergency Medicine

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“…However, early diagnosis is sometimes difficult due to the non-specific symptoms, and the condition is sometimes misdiagnosed as arterial dissection, myocardial infarction, pulmonary infarction, or aspiration pneumonia 3) . The rate of correct diagnosis at the time of initial examination is reported to be low, at 30-50% 8,9) . The rupture was misdiagnosed initially in 4 of our 10 patients as pneumonia (1 patient), gastric ulcer (1 patient), cholecystitis (1 patient), and epigastric pain (1 patient).…”

Section: Discussionmentioning

confidence: 99%

Surgical Management of Spontaneous Esophageal Rupture: An Evaluation

Mikami

Fukunaga

Enomoto

et al. 2015

J St. Marianna Univ

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Spontaneous esophageal rupture is rare. The distal esophagus ruptures upon a sudden vomiting-induced increase in the internal esophageal pressure. We evaluated surgical management of spontaneous esophageal rupture by examining clinical details and outcomes of 10 patients treated for the disorder at our hospital between 1987 and 2014.Mean age of the patients was 58.1 years (range, 41-75 years). The sex ratio (M/F) was 9/1. Diagnosis was achieved by chest computed tomography (CT) or chest CT and esophagography. The rupture occurred in the left lower thoracic esophagus (n=8), left middle thoracic esophagus (n=1), or right lower thoracic esophagus (n=1). Mean time from symptom onset to surgery was 36.2 hours (range, 5-96 hours).Patients were divided between those treated within 24 hours of onset (early treatment group, n=5) and those treated 24 hours or more after onset (late treatment group, n=5). Treatment comprised primary repair in 7 patients and esophagectomy in 3. Postoperative complications occurred in 6 patients: surgical site infection (n=4), anastomosis leakage (n=3), intrapleural abscess (n=1), sepsis (n=1), and pneumonia (n=1). Mean postoperative hospital stay was78.5 days (range, 22-228 days). There was no in-hospital mortality.Postoperative complications were somewhat more frequent in the late treatment group (n=4, 80%) than in the early treatment group (n=3, 60%), and postoperative hospital stay was longer in this group (114.2 vs. 42.8 days). Outcomes in terms of postoperative complications and hospital stay were good in the early treatment group. In the late treatment group, severe intrathoracic contamination in 3 patients necessitated life-saving esophagectomy. When primary repair was performed, the incidence of anastomotic leakage was lowest when both layers were sutured, perforation sites were reinforced, and nutritional support was provided.Early diagnosis and treatment are essential for spontaneous esophageal rupture, and we believe that selecting the appropriate surgical technique increases survival.

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Spontaneous rupture of the oesophagus. Avoidance of postoperative morbidity

Cited by 52 publications

References 26 publications

Rupture of the abdominal oesophagus: A review

Rupture of the abdominal oesophagus: A review

A Case of Rapid Diagnosis of Boerhaave Syndrome by Thoracic Drainage

Surgical Management of Spontaneous Esophageal Rupture: An Evaluation

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