Spontaneous rupture of the oesophagus

Abstract

Since the first report by Barrett, in 1947, of successful suture of a spontaneous rupture of the oesophagus, many survivals from this disaster have been reported. Unfortunately the condition is still frequently not diagnosed at an early stage. The history is usually characteristic, with sudden severe retrosternal or interscapular pain following vomiting. When this story is accompanied by rapid respiration and surgical emphysema in the supraclavicular areas, or mediastinal emphysema on radiographs, the diagnosis is certain, although there are pitfalls as the following case illustrates.