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December 1970

Spontaneous Rupture of the Esophagus

Arch Intern Med. 1970;126(6):1008-1009. doi:10.1001/archinte.1970.00310120070009

We wish to report a case of spontaneous rupture of the esophagus with recovery following surgery in a patient who previously had a partial gastrectomy and vagotomy. The presenting clinical features were epigastric and chest pain, vomiting, hematemesis, and hemothorax. The classical clinical signs of shock, mediastinal or subcutaneous emphysema and pneumothorax were missing in our patient. The radiological visualization of the rupture succeeded only on the third attempt.

Patient Summary  A 33-year-old male, chronic alcoholic was admitted to our hospital on the night of July 24, 1969, with the chief complaints of pain in the epigastric region and left costal margin, and vomiting of five days' duration. One episode of hematemesis occurred prior to admission.A partial gastrectomy and vagotomy had been performed in 1960 for peptic ulcer.On examination the patient was in mild respiratory distress, but not cyanotic.