Spontan øsofagusruptur

Abstract

Background: Spontaneous rupture of the oesophagus is a potentially fatal condition. Symptoms can vary and diagnosis can be challenging.

Case presentation: A woman in her seventies presented to the emergency department with sudden-onset epigastric pain after a meal. A computed tomography (CT) showed signs of oesophageal rupture. Upper gastrointestinal endoscopy revealed an oesophageal rupture, and a stent was placed. The patient developed fever, dyspnoea and hypotension after the procedure. Additional CT revealed increasing pleural effusion, pneumomediastinum and loculaments of air in the peritoneum, and a mediastinal abscess. Laparoscopy with lavage and debridement was performed. A catheter was placed in the abscess and a chest tube in her right hemithorax. The stent was removed after 27 days. Further investigation revealed eosinophil oesophagitis as the likely cause of her oesophageal rupture.

Interpretation: This case highlights the importance of early diagnosis and proper treatment of spontaneous oesophageal rupture. Treatment depends on the cause of the rupture and severity of the patient's condition.