Korn Owen, Oñate Juan C, López René
Department of Surgery, Clinical Hospital University of Chile, Santiago, Chile.
Surgery. 2007 Feb;141(2):222-8. doi: 10.1016/j.surg.2006.06.034. Epub 2006 Sep 25.
Spontaneous rupture of the esophagus (Boerhaave syndrome) occurs almost invariably at the same anatomic site. A weakness of the distal esophageal wall is suspected but has not been confirmed by anatomic studies. The aim of this work was to determine the existence of a structural abnormality in the esophageal wall.
In six fresh human cadavers, the left lung was removed and the esophagus was insufflated in situ with air until it burst. The mucosa of the specimens was stripped off, allowing the fibers of the inner muscular coat to be seen. In addition a specimen from a patient who died from this cause was submitted to the same procedure.
The site of the experimental rupture matched the clinical case. The tear was located at the margin of contact between "clasp" and oblique fibers, and extends upwards.
The connective tissue of the junction between clasp and oblique fibers appears to constitute a weak point in the lower esophagus.
食管自发性破裂（博赫哈夫综合征）几乎总是发生在相同的解剖部位。怀疑食管远端壁存在薄弱点，但解剖学研究尚未证实。这项研究的目的是确定食管壁是否存在结构异常。
在六具新鲜人体尸体中，切除左肺，在原位向食管内注入空气直至其破裂。将标本的黏膜剥离，以便观察内层肌层的纤维。此外，对一名因该病因死亡的患者的标本进行了相同的操作。
实验性破裂的部位与临床病例相符。撕裂位于“扣状”纤维与斜纤维接触的边缘，并向上延伸。
扣状纤维与斜纤维交界处的结缔组织似乎构成了食管下段的一个薄弱点。
