Laparoscopic Intra-Mediastinum Omental Filling Repair for Spontaneous Esophageal Rupture: A Case Report.

Abstract

Introduction: Spontaneous esophageal rupture is a rare but life-threatening condition with a high mortality rate. While conservative and endoscopic therapies have been reported, surgical treatment remains essential. The optimal approach involves esophageal defect repair and mediastinal drainage, which is performed via laparotomy, thoracotomy, laparoscopy, or a combination of these techniques. We report a case of laparoscopic intramediastinal omental filling for a spontaneous esophageal rupture that was challenging to close.

Case presentation: A 62-year-old man presented with sudden-onset right-sided abdominal pain. Computed tomography and esophagography revealed a spontaneous rupture of the right wall of the lower esophagus. Laparoscopic surgery was performed 4 h following symptom onset. A partially necrotic area was identified in the lower esophagus. Given the difficulty of suturing the necrotic esophageal wall, the mediastinum was filled with the greater omentum to cover the perforation site. The patient had no significant postoperative complications and was discharged on the 24th postoperative day.

Conclusions: Laparoscopic omental filling repair is a viable option for esophageal rupture when primary suture closure is not feasible.