Tormund Haugland Njølstad, Jonas Torp Ohlsen, Marjolein Henrieke Liedenbaum, Jon Meyer Tvinnereim, Øyvind Bruserud
{"title":"自发性食道破裂。","authors":"Tormund Haugland Njølstad, Jonas Torp Ohlsen, Marjolein Henrieke Liedenbaum, Jon Meyer Tvinnereim, Øyvind Bruserud","doi":"10.4045/tidsskr.24.0145","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Spontaneous rupture of the oesophagus is a potentially fatal condition. Symptoms can vary and diagnosis can be challenging.</p><p><strong>Case presentation: </strong>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.</p><p><strong>Interpretation: </strong>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.</p>","PeriodicalId":23123,"journal":{"name":"Tidsskrift for Den Norske Laegeforening","volume":"144 11","pages":""},"PeriodicalIF":1.2000,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Spontan øsofagusruptur.\",\"authors\":\"Tormund Haugland Njølstad, Jonas Torp Ohlsen, Marjolein Henrieke Liedenbaum, Jon Meyer Tvinnereim, Øyvind Bruserud\",\"doi\":\"10.4045/tidsskr.24.0145\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Spontaneous rupture of the oesophagus is a potentially fatal condition. Symptoms can vary and diagnosis can be challenging.</p><p><strong>Case presentation: </strong>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.</p><p><strong>Interpretation: </strong>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.</p>\",\"PeriodicalId\":23123,\"journal\":{\"name\":\"Tidsskrift for Den Norske Laegeforening\",\"volume\":\"144 11\",\"pages\":\"\"},\"PeriodicalIF\":1.2000,\"publicationDate\":\"2024-09-23\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Tidsskrift for Den Norske Laegeforening\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.4045/tidsskr.24.0145\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/9/24 0:00:00\",\"PubModel\":\"Print\",\"JCR\":\"Q2\",\"JCRName\":\"MEDICINE, GENERAL & INTERNAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Tidsskrift for Den Norske Laegeforening","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.4045/tidsskr.24.0145","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/9/24 0:00:00","PubModel":"Print","JCR":"Q2","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
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.