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Relationship of Peptic Esophagitis to Spontaneous Rupture of Esophagus

Relationship of Peptic Esophagitis to Spontaneous Rupture of Esophagus Abstract 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 References 1. Anderson, R. L.: Rupture of the Esophagus , J. Thoracic Surg. 24:369-388, 1952. 2. Barrett, N. R.: Report of a Case of Spontaneous Perforation. of the Œsophagus Successfully Treated by Operation , Brit. J. Surg. 35:216-218, 1947.Crossref 3. Kinsella, T. J.: Spontaneous Rupture of the Esophagus , J. Thoracic Surg. 17:613-631, 1948. 4. Bunch, G. H., Jr.: Spontaneous Rupture of the Esophagus , Ann. Surg. 145:1001-1008, 1957.Crossref 5. Cushing, H.: Peptic Ulcers and Interbrain , Surg. Gynec. & Obst. 55:1-34, 1932. 6. Derbes, V. J., and Mitchell, R. E., Jr.: Rupture of the Esophagus , Surgery 39:865-888, 1956. 7. Derrick, J. R.; Harrison, W. H., and Howard, J. M.: Factors Predisposing to Spontaneous Perforation of the Esophagus , Surgery 43:486-489, 1958. 8. Eliason, E. L., and Welty, R. F.: Spontaneous Rupture of the Esophagus , Surg. Gynec. & Obst. 83:234-238, 1946. 9. Dorsey, J. M., and Kyser, F. A.: Perforated Peptic Esophagitis , Quart. Bull. Northwestern Univ. M. School 29:120-124, 1955. 10. Ferguson, D. J.; Sanchez-Palomera, E.; Sako, Y.; Clatworthy, H. W., Jr.; Toon, R. W., and Wangensteen, O.: Studies on Experimental Esophagitis , Surgery 28:1022-1039, 1950. 11. Graham, E. A.: Editorial Comment , Year Book of General Surgery , edited by E. A. Graham, Chicago, The Year Book Publishers, Inc., 1944, p. 382. 12. Harrington, S.: Personal communication to the authors. 13. Kinsella, T. J.; Morse, R. W., and Hertzog, A. J.: Spontaneous Rupture of the Esophagus , J. Thoracic Surg. 17:613-631, 1948. 14. Mackler, S. A.: Spontaneous Rupture of the Esophagus: Experimental and Clinical Study , Surg. Gynec. & Obst. 95:345-356, 1952. 15. Olsen, A. M., and Clagett, O. T.: Spontaneous Rupture of the Esophagus: Report of Case, with Immediate Diagnosis and Successful Surgical Repair , Postgrad. Med. 2:417-421, 1947. 16. Richter, H. M., Jr.; Davis, R. A.; Ruge, D., and Walter, N. T.: The Effect of Cortical and Subcortical Brain Lesions upon Gastric Secretion in Dogs with a Vagus-Preserved Total Gastric Pouch , S. Forum 7:524-528, 1957. 17. Samson, P. C.: Postemetic Rupture of the Esophagus , Surg. Gynec. & Obst. 93:221-229, 1951. 18. Weiss, S., and Mallory, G. K.: Lesions of the Cardiac Orifice of the Stomach Produced by Vomiting , J. A. M. A. 98:1353-1355, 1932. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png A.M.A. Archives Surgery American Medical Association

Relationship of Peptic Esophagitis to Spontaneous Rupture of Esophagus

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References (17)

Publisher
American Medical Association
Copyright
Copyright © 1959 American Medical Association. All Rights Reserved.
ISSN
0096-6908
DOI
10.1001/archsurg.1959.04320060066009
Publisher site
See Article on Publisher Site

Abstract

Abstract 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 References 1. Anderson, R. L.: Rupture of the Esophagus , J. Thoracic Surg. 24:369-388, 1952. 2. Barrett, N. R.: Report of a Case of Spontaneous Perforation. of the Œsophagus Successfully Treated by Operation , Brit. J. Surg. 35:216-218, 1947.Crossref 3. Kinsella, T. J.: Spontaneous Rupture of the Esophagus , J. Thoracic Surg. 17:613-631, 1948. 4. Bunch, G. H., Jr.: Spontaneous Rupture of the Esophagus , Ann. Surg. 145:1001-1008, 1957.Crossref 5. Cushing, H.: Peptic Ulcers and Interbrain , Surg. Gynec. & Obst. 55:1-34, 1932. 6. Derbes, V. J., and Mitchell, R. E., Jr.: Rupture of the Esophagus , Surgery 39:865-888, 1956. 7. Derrick, J. R.; Harrison, W. H., and Howard, J. M.: Factors Predisposing to Spontaneous Perforation of the Esophagus , Surgery 43:486-489, 1958. 8. Eliason, E. L., and Welty, R. F.: Spontaneous Rupture of the Esophagus , Surg. Gynec. & Obst. 83:234-238, 1946. 9. Dorsey, J. M., and Kyser, F. A.: Perforated Peptic Esophagitis , Quart. Bull. Northwestern Univ. M. School 29:120-124, 1955. 10. Ferguson, D. J.; Sanchez-Palomera, E.; Sako, Y.; Clatworthy, H. W., Jr.; Toon, R. W., and Wangensteen, O.: Studies on Experimental Esophagitis , Surgery 28:1022-1039, 1950. 11. Graham, E. A.: Editorial Comment , Year Book of General Surgery , edited by E. A. Graham, Chicago, The Year Book Publishers, Inc., 1944, p. 382. 12. Harrington, S.: Personal communication to the authors. 13. Kinsella, T. J.; Morse, R. W., and Hertzog, A. J.: Spontaneous Rupture of the Esophagus , J. Thoracic Surg. 17:613-631, 1948. 14. Mackler, S. A.: Spontaneous Rupture of the Esophagus: Experimental and Clinical Study , Surg. Gynec. & Obst. 95:345-356, 1952. 15. Olsen, A. M., and Clagett, O. T.: Spontaneous Rupture of the Esophagus: Report of Case, with Immediate Diagnosis and Successful Surgical Repair , Postgrad. Med. 2:417-421, 1947. 16. Richter, H. M., Jr.; Davis, R. A.; Ruge, D., and Walter, N. T.: The Effect of Cortical and Subcortical Brain Lesions upon Gastric Secretion in Dogs with a Vagus-Preserved Total Gastric Pouch , S. Forum 7:524-528, 1957. 17. Samson, P. C.: Postemetic Rupture of the Esophagus , Surg. Gynec. & Obst. 93:221-229, 1951. 18. Weiss, S., and Mallory, G. K.: Lesions of the Cardiac Orifice of the Stomach Produced by Vomiting , J. A. M. A. 98:1353-1355, 1932.

Journal

A.M.A. Archives SurgeryAmerican Medical Association

Published: Jun 1, 1959

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