Spontaneous Rupture of Esophagus refers to a full-thickness longitudinal tear in the left wall of the esophagus near the diaphragm caused by a sudden increase in intraluminal pressure. It is also known as Boerhaave syndrome, spontaneous esophageal tear syndrome, or esophageal pressure rupture.

bubble_chart Pathological Changes

Similar to Mallory-Weiss syndrome.

bubble_chart Clinical Manifestations

Severe retrosternal or epigastric pain occurs suddenly with vomiting, and shock, rapid pulse, dyspnea, and cyanosis may develop within 1–2 hours after onset. Based on a history of heavy drinking, retrosternal or epigastric pain following severe vomiting, and subcutaneous emphysema in the suprasternal and supraclavicular fossae.

bubble_chart Diagnosis

In the upper abdomen, muscle tension and tenderness are often present without the disappearance of liver dullness, while Hamman's sign and X-ray examination are of significant importance for diagnosis.

bubble_chart Treatment Measures

Once diagnosed, the disease should be immediately treated with antibiotics and shock resuscitation. Surgical intervention should be performed as early as possible to remove irritating fluids and repair the esophageal rupture. Without timely treatment, patients may die from severe necrotizing mediastinitis and internal toxin shock, with a mortality rate ranging from 30% to 70%.