Whelan Stephanie, Kelly Matthew
Redlands Hospital, 54 Glen St, Kelvin Grove, QLD, 4059, Australia.
Beaudesert Hospital, Beaudesert, Queensland, Australia.
J Med Case Rep. 2017 Nov 6;11(1):313. doi: 10.1186/s13256-017-1482-1.
Esophageal rupture is an extremely rare condition to occur to a pregnant or postnatal woman. Esophageal ruptures have been previously described in the literature; however, they are most common in the setting of hyperemesis gravidarum.
This case report describes a 27-year-old white woman who began complaining of central chest pain and shortness of breath 3 hours after a normal vaginal delivery, with no history of vomiting antenatally or intrapartum. A chest X-ray and computed tomography pulmonary angiogram confirmed surgical emphysema and pneumomediastinum, and a diagnosis of esophageal rupture was made based on these findings. She was stable and conservative management was initiated; she improved over 4 days. Resolution of surgical emphysema was demonstrated on serial chest X-rays without requiring contrast swallow or surgical intervention.
This case exemplifies the importance of a timely diagnosis of esophageal rupture in ensuring a positive outcome for the patient. Delay in diagnosis can lead to an increase in morbidity and mortality.
食管破裂在孕妇或产后女性中极为罕见。此前文献中已有食管破裂的描述；然而，它们在妊娠剧吐的情况下最为常见。
本病例报告描述了一名27岁的白人女性，她在正常阴道分娩3小时后开始抱怨胸部中央疼痛和呼吸急促，产前或产时均无呕吐史。胸部X线和计算机断层扫描肺动脉造影证实了手术性气肿和纵隔气肿，并根据这些发现做出了食管破裂的诊断。她情况稳定，开始进行保守治疗；4天后病情好转。连续胸部X线显示手术性气肿消退，无需吞咽造影剂或手术干预。
本病例体现了及时诊断食管破裂对确保患者获得良好预后的重要性。诊断延迟会导致发病率和死亡率增加。
