-Case Reports-

Successful Treatment of a Spontaneous Esophageal Rupture in an Elderly Patient: A Case Report

Eriko Shinozuka, Tsutomu Nomura, Masao Miyashita, Hiroshi Makino, Keiichi Okawa, Nobutoshi Hagiwara, Kengo Shigehara, Ichiro Akagi, Yoshinobu Shioda and Eiji Uchida

Surgery for Organ Function and Biological Regulation, Graduate School of Medicine, Nippon Medical School

An 80-year-old woman was admitted to our hospital with severe chest and back pains after vomiting. Computed tomography (CT) of the chest revealed left-sided pneumothorax and pleural effusion. Some food was drained from an inserted chest tube, and we diagnosed spontaneous esophageal rupture (Boerhaave's syndrome). A left thoracotomy was performed 7 hours after the onset of symptoms. A 3-cm perforation was discovered in the lateral wall of the distal esophagus. The perforation was repaired with a primary two-layered closure and covered with pericardial fat. The patient had a good postoperative course and was discharged 1 month after surgery. This case suggests the importance of early surgical treatment, even in elderly patients with spontaneous esophageal rupture.

J Nippon Med Sch 2010; 77: 338-341

Keywords
spontaneous esophageal rupture, primary repair, old age

Correspondence to
Eriko Shinozuka, Department of Surgery, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan
shinozuka@nms.ac.jp

Received, August 25, 2010
Accepted, October 16, 2010