Gieseler H, Wrede F
MMW Munch Med Wochenschr. 1980 Oct 10;122(41):1427-30.
Spontaneous rupture of the esophagus is a rare occurrence. Etiologically, a rise in pressure in the gullet far above the physiological extent is prominent with the result that the wall of the esophagus bursts in the distal third. Usually an enormous meal has been taken previously, with large amounts of alcohol. Repeated severe vomiting, often accompanied by diarrhea, may give rise to increased pressure in the distal esophagus which triggers the bursting mechanism. With one of our patients as an example, after a short description of the diagnosis the early indication for operation is seen to be decisive. The surgical method of choice is the over-suture of the rupture site and thoracic drainage. In contrast to spontaneous rupture of the esophagus, instrumental perforations of this organ are usually treated conservatively.
食管自发性破裂是一种罕见的情况。从病因学角度来看，食管内压力大幅上升远超生理范围，这一情况较为突出，其结果是食管壁在远端三分之一处破裂。通常患者此前会摄入大量食物，并伴有大量饮酒。反复剧烈呕吐，常伴有腹泻，可能导致食管远端压力升高，从而引发破裂机制。以我们的一位患者为例，在简短描述诊断情况后，可以看出早期手术指征具有决定性意义。首选的手术方法是对破裂部位进行缝合及胸腔引流。与食管自发性破裂不同，该器官的器械穿孔通常采用保守治疗。
