Spontan øsofagusruptur.

IF 1.2 Q2 MEDICINE, GENERAL & INTERNAL

Tidsskrift for Den Norske Laegeforening Pub Date : 2024-09-23 Print Date: 2024-09-24 DOI:10.4045/tidsskr.24.0145

Tormund Haugland Njølstad, Jonas Torp Ohlsen, Marjolein Henrieke Liedenbaum, Jon Meyer Tvinnereim, Øyvind Bruserud

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Abstract

Background: Spontaneous rupture of the oesophagus is a potentially fatal condition. Symptoms can vary and diagnosis can be challenging.

Case presentation: A woman in her seventies presented to the emergency department with sudden-onset epigastric pain after a meal. A computed tomography (CT) showed signs of oesophageal rupture. Upper gastrointestinal endoscopy revealed an oesophageal rupture, and a stent was placed. The patient developed fever, dyspnoea and hypotension after the procedure. Additional CT revealed increasing pleural effusion, pneumomediastinum and loculaments of air in the peritoneum, and a mediastinal abscess. Laparoscopy with lavage and debridement was performed. A catheter was placed in the abscess and a chest tube in her right hemithorax. The stent was removed after 27 days. Further investigation revealed eosinophil oesophagitis as the likely cause of her oesophageal rupture.

Interpretation: This case highlights the importance of early diagnosis and proper treatment of spontaneous oesophageal rupture. Treatment depends on the cause of the rupture and severity of the patient's condition.

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自发性食道破裂。

背景：食道自发性破裂是一种潜在的致命疾病。症状各不相同，诊断也很困难：一名七十多岁的妇女因餐后突发上腹部疼痛到急诊科就诊。计算机断层扫描（CT）显示有食道破裂的迹象。上消化道内窥镜检查显示食道破裂，并放置了支架。术后患者出现发热、呼吸困难和低血压。进一步的 CT 检查发现胸腔积液、气胸、腹膜积气和纵隔脓肿不断增加。患者接受了腹腔镜灌洗和清创术。在脓肿中放置了一根导管，并在她的右半胸放置了一根胸管。27 天后，支架被移除。进一步检查发现，嗜酸性粒细胞食管炎可能是导致她食管破裂的原因：本病例强调了早期诊断和正确治疗自发性食管破裂的重要性。治疗方法取决于破裂的原因和患者病情的严重程度。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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