Esophageal Rupture - Causes, Symptoms & Treatment

An esophageal rupture occurs when there is a tear in the esophagus. The esophagus is the tube that connects the mouth with the stomach. Cancer of the esophagus, ingesting corrosive fluids, forceful vomiting, and trauma can all lead to this condition. Leakage of food or fluid from the esophagus into the structures of the chest can lead to serious irritation and infection.

Esophageal rupture may be iatrogenic during endoscopic procedures or other instrumentation or may be spontaneous (Boerhaave's syndrome). Other causes of spontaneous perforation include caustic ingestion, pill esophagitis, Barrett's ulcer, infectious ulcers in patients with AIDS, and following dilation of esophageal strictures.

In most cases of Boerhaave's syndrome, the tear occurs at the left posterolateral aspect of the distal esophagus and extends for several centimeters. The condition is associated with high morbidity and mortality and is fatal in the absence of therapy. The occasionally nonspecific nature of the symptoms may contribute to a delay in diagnosis and a poor outcome.

Spontaneous effort rupture of the cervical esophagus, leading to localized cervical perforation, may be more common than previously recognized and has a generally benign course. Preexisting esophageal disease is not a prerequisite for esophageal perforation but it contributes to increased mortality.

Causes of Esophageal Rupture

Find common causes and risk factors of Esophageal Rupture:

• Severe injury or trauma to the esophagus .
• Cancer of the esophagus .
• Swallowing cleaning fluids, strong chemicals or a foreign object .
• Lifting a heavy object .
• Ulcers in the esophagus .

Signs and Symptoms of Esophageal Rupture

Symptoms include chest and abdominal pain, vomiting, hematemesis, and shock. Subcutaneous emphysema is palpable in about 30% of patients. Mediastinal crunch (Hamman's sign), a crackling sound synchronous with the heartbeat, may be present.

• Fever.
• Nausea.
• Mild to severe chest pain.
• Vomiting, sometimes with blood in the vomit.
• Fast breathing.

Treatment for Esophageal Rupture

Treatment may include:

• Ruptures must be cleaned and repaired immediately by a surgeon.

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