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December 1961

Spontaneous Rupture of the Esophagogastric Junction: Report of a Case Treated Successfully Through a Thoracoabdominal Incision

Author Affiliations

From the Department of Surgery, Veterans Administration Hospital, Philadelphia 4.; Formerly. Senior Resident in Surgery, Veterans Administration Hospital, Philadelphia (Dr. Perkoff); Formerly Chief, Thoracic Surgery, Veterans Administration Hospital, Philadelphia, and presently at University Hospital, Iowa City, Iowa (Dr. Sensenig).

Arch Surg. 1961;83(6):808-812. doi:10.1001/archsurg.1961.01300180008002

Survival following spontaneous rupture of the esophagus is no longer considered a clinical oddity. Ware,10 in his review of the literature through 1952, reported 17 survivors following treatment. Mackler,7 reviewing the same time interval, reported only 13 survivors, 11 of whom were treated by suture of the ruptured esophagus. Approximately another 50 survivors have been reported since 1952, 41 of whom were treated by surgical repair. The figures vary with the definition of a "spontaneous rupture" and with the recognition of overlapping reports.

In our review of the literature, spontaneous rupture across the esophagogastric junction has been a very rare occurrence, and we have found no previous description of repair by a thoracoabdominal approach. Sencert9 in 1911 reported the first and one of the few cases of rupture extending below the diaphragm. Mackler7 in 1952 described 2 cases in which the perforation extended to the cardia