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Perforation of Stress Ulcers of the Esophagus Following Thermal Burns: Report of Two Patients

Perforation of Stress Ulcers of the Esophagus Following Thermal Burns: Report of Two Patients Abstract Introduction Perforation of the esophagus and rupture of the esophagus have usually been described as separate entities. By definition, perforation of the esophagus signifies an erosion of the wall of the esophagus, except when produced by trauma or by instrumentation. Rupture of the esophagus refers to a tear in an undiseased esophagus. Welldocumented reports cite pure examples of each entity. The following two cases lend impetus to the concept21 that a combination of the two factors, perforation and rupture, is present, the tenet being that ulceration of the mucosa destroys the strongest layer of the esophagus, predisposing it to rupture should the intraesophageal pressure be suddenly increased by vomiting. Report of Cases Case 1. —A 16-year-old white youth was admitted to the emergency clinic of Grady Memorial Hospital at 2:30 a.m., Aug. 11, 1954. Thirty minutes prior to admission he had been hitchhiking. When a driver stopped his car References 1. Andrews, E. W.: Pneumatic Rupture of Intestine , Surg. Gynec. & Obst. 12:63, 1911. 2. Boyd, D. P., and Eytinge, E. J.: Perforation of Esophagus: A Complication of Obstructing Duodenal Ulcer , Gastroenterology 17:103, 1951. 3. Burt, C. A. V.: Pneumatic Rupture of Intestinal Canal , Arch. Surg. 22:875, 1931. 4. Butin, J. W.; Olsen, A. M.; Moersch, H. J., and Code, C. F.: Study of Esophageal Pressures in Normal Persons and Patients with Cardiospasm , Gastroenterology 23:278, 1953. 5. Cushing, H.: Peptic Ulcers and the Interbrain , Surg. Gynec. & Obst. 55:1-34, 1932. 6. Derrick, J. R.: Unpublished data. 7. Erskine, F. A.; Mason, J. H., Jr., and McDade, H.: Perforation of Esophageal Ulcers in Bulbar Poliomyelitis , Am. J. Med. 8:239, 1950. 8. Fincher, E. F., and Swanson, H. S.: Esophageal Rupture Complicating Craniotomy: Symptom Complex and Proposed Surgical Treatment , Ann. Surg. 129:619, 1949. 9. Friesen, S. R.: The Genesis of Gastroduodenal Ulcers Following Burns: Experimental Study , Surgery 28:123, 1950. 10. Gray, S. J.; Benson, J. A.; Reifenstein, R. W., and Spiro, H. M.: Chronic Stress and Peptic Ulcers: Effect of Corticotropin (ACTH) and Cortisone on Gastric Secretion , J. A. M. A. 147:1529, 1951. 11. Hardy, J. D.: The Adrenal Cortex and Postoperative Gastrointestinal Secretions: Clinical Significance of These Effects , Surgery 29:517, 1951. 12. Howard, J. M.: Gastric and Salivary Secretions Following Injury , Ann. Surg. 141:342, 1955. 13. Irvin, C. W., and Bunch, G. H.: Spontaneous Rupture of Esophagus , Am. J. Med. 17:571, 1954. 14. Layne, J. A., and Hildebrand, E.: Rupture of Esophagus Following Severe Vomiting , Gastroenterology 13:170, 1949. 15. Mackenzie, M.: A Manual of Disease of the Throat and Nose , New York, Wm. Wood & Co., 1880, Sect. 4, p. 113. 16. Mackler, S. A.: Spontaneous Rupture of Esophagus , Surg. Gynec. & Obst. 95:345, 1952. 17. Mellins, H. Z.: Esophageal Ulcer in Infancy , Am. J. Roentgenol. 68:634, 1952. 18. Muendel, H. J., and Levison, W.: Spontaneous Rupture of Esophagus , A. M. A. Arch. Surg. 67:943, 1953. 19. Palmer, E. D.: Attempt to Localize the Normal Esophagogastric Junction , Radiology 60:825, 1953. 20. Rankin, L. M.: Perforation of Esophagus After Burn , Am. J. Surg. 67:134, 1945. 21. Kirby, C. K.: "Spontaneous" Rupture of the Esophagus , Am. J. M. Sc. 229:199, 1955. 22. Selye, H.: The Alarm Reaction and the Disease of Adaptation , Ann. Int. Med. 29:403, 1948. 23. Weigel, A. E.; Artz, C. P.; Reiss, E.; Davis. J. H., and Amspacher, W. H.: Gastrointestinal Ulcerations Complicating Burns , Surgery 34:826, 1953. 24. Woldman, E. E.: Acute Ulcers of Upper Gastrointestinal Tract , J. A. M. A. 149:984, 1952.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png A.M.A. Archives Surgery American Medical Association

Perforation of Stress Ulcers of the Esophagus Following Thermal Burns: Report of Two Patients

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References (30)

Publisher
American Medical Association
Copyright
Copyright © 1957 American Medical Association. All Rights Reserved.
ISSN
0096-6908
DOI
10.1001/archsurg.1957.01280130021004
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Abstract

Abstract Introduction Perforation of the esophagus and rupture of the esophagus have usually been described as separate entities. By definition, perforation of the esophagus signifies an erosion of the wall of the esophagus, except when produced by trauma or by instrumentation. Rupture of the esophagus refers to a tear in an undiseased esophagus. Welldocumented reports cite pure examples of each entity. The following two cases lend impetus to the concept21 that a combination of the two factors, perforation and rupture, is present, the tenet being that ulceration of the mucosa destroys the strongest layer of the esophagus, predisposing it to rupture should the intraesophageal pressure be suddenly increased by vomiting. Report of Cases Case 1. —A 16-year-old white youth was admitted to the emergency clinic of Grady Memorial Hospital at 2:30 a.m., Aug. 11, 1954. Thirty minutes prior to admission he had been hitchhiking. When a driver stopped his car References 1. Andrews, E. W.: Pneumatic Rupture of Intestine , Surg. Gynec. & Obst. 12:63, 1911. 2. Boyd, D. P., and Eytinge, E. J.: Perforation of Esophagus: A Complication of Obstructing Duodenal Ulcer , Gastroenterology 17:103, 1951. 3. Burt, C. A. V.: Pneumatic Rupture of Intestinal Canal , Arch. Surg. 22:875, 1931. 4. Butin, J. W.; Olsen, A. M.; Moersch, H. J., and Code, C. F.: Study of Esophageal Pressures in Normal Persons and Patients with Cardiospasm , Gastroenterology 23:278, 1953. 5. Cushing, H.: Peptic Ulcers and the Interbrain , Surg. Gynec. & Obst. 55:1-34, 1932. 6. Derrick, J. R.: Unpublished data. 7. Erskine, F. A.; Mason, J. H., Jr., and McDade, H.: Perforation of Esophageal Ulcers in Bulbar Poliomyelitis , Am. J. Med. 8:239, 1950. 8. Fincher, E. F., and Swanson, H. S.: Esophageal Rupture Complicating Craniotomy: Symptom Complex and Proposed Surgical Treatment , Ann. Surg. 129:619, 1949. 9. Friesen, S. R.: The Genesis of Gastroduodenal Ulcers Following Burns: Experimental Study , Surgery 28:123, 1950. 10. Gray, S. J.; Benson, J. A.; Reifenstein, R. W., and Spiro, H. M.: Chronic Stress and Peptic Ulcers: Effect of Corticotropin (ACTH) and Cortisone on Gastric Secretion , J. A. M. A. 147:1529, 1951. 11. Hardy, J. D.: The Adrenal Cortex and Postoperative Gastrointestinal Secretions: Clinical Significance of These Effects , Surgery 29:517, 1951. 12. Howard, J. M.: Gastric and Salivary Secretions Following Injury , Ann. Surg. 141:342, 1955. 13. Irvin, C. W., and Bunch, G. H.: Spontaneous Rupture of Esophagus , Am. J. Med. 17:571, 1954. 14. Layne, J. A., and Hildebrand, E.: Rupture of Esophagus Following Severe Vomiting , Gastroenterology 13:170, 1949. 15. Mackenzie, M.: A Manual of Disease of the Throat and Nose , New York, Wm. Wood & Co., 1880, Sect. 4, p. 113. 16. Mackler, S. A.: Spontaneous Rupture of Esophagus , Surg. Gynec. & Obst. 95:345, 1952. 17. Mellins, H. Z.: Esophageal Ulcer in Infancy , Am. J. Roentgenol. 68:634, 1952. 18. Muendel, H. J., and Levison, W.: Spontaneous Rupture of Esophagus , A. M. A. Arch. Surg. 67:943, 1953. 19. Palmer, E. D.: Attempt to Localize the Normal Esophagogastric Junction , Radiology 60:825, 1953. 20. Rankin, L. M.: Perforation of Esophagus After Burn , Am. J. Surg. 67:134, 1945. 21. Kirby, C. K.: "Spontaneous" Rupture of the Esophagus , Am. J. M. Sc. 229:199, 1955. 22. Selye, H.: The Alarm Reaction and the Disease of Adaptation , Ann. Int. Med. 29:403, 1948. 23. Weigel, A. E.; Artz, C. P.; Reiss, E.; Davis. J. H., and Amspacher, W. H.: Gastrointestinal Ulcerations Complicating Burns , Surgery 34:826, 1953. 24. Woldman, E. E.: Acute Ulcers of Upper Gastrointestinal Tract , J. A. M. A. 149:984, 1952.Crossref

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A.M.A. Archives Surgery – American Medical Association

Published: Jul 1, 1957

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