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June 1959

Relationship of Peptic Esophagitis to Spontaneous Rupture of Esophagus

Author Affiliations

Evanston, III.
From the Department of Surgery, Northwestern Medical School, Chicago, and the Evanston Hospital.; Professor of Surgery (Dr. Dorsey); Associate in Surgery (Dr. Hohf), Northwestern Medical School. Formerly Chief Surgical Resident, Evanston Hospital; now at Gosin-Lynn Clinic, Green Bay Wis. (Dr. Lynn).

AMA Arch Surg. 1959;78(6):878-888. doi:10.1001/archsurg.1959.04320060066009

Spontaneous rupture of the esophagus is a serious, and often fatal, condition unless there is prompt surgical intervention. The onset of symptoms is usually abrupt and almost always related to an episode of vomiting. The most frequent site of rupture is at the inferior end of the esophagus and on the left. Initially, severe lower substernal or upper abdominal pain with associated shock may be preponderant. Diagnostic confusion with more frequently encountered conditions of the thorax or upper abdomen is common. Subsequently the features of mediastinitis, with usually an associated hydropneumothorax, predominate. The fulminating course and high mortality in untreated patients make early recognition and operative intervention urgent.

A review of the Evanston Hospital records prior to 1946 failed to disclose a reported case of spontaneous rupture of the esophagus. Since that time nine such instances have been encountered. These cases form the basis of this report.

Background  Rupture of