Shimada M, Okagawa K, Mizunoya S, Kaneko T, Takayama T, Hirao M
Department of Surgery, Kinki Central Hospital, Itami, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1995 Mar;43(3):355-60.
Since cases of spontaneous rupture of the esophagus are extremely rare and early symptoms of the disease are similar to those of emergency diseases of the chest and abdomen, the diagnosis and treatments are often delayed, resulting in an unfavorable outcome in some cases. A 49-year-old man had suffered from severe chest pain and postemetic hematemesis after consuming some alcohol. Because the patient was diagnosed as having a spontaneous rupture of the esophagus, the patient was referred to our hospital and underwent surgery 25 hours after the onset. There was a 3-cm vertical perforation in the left wall of the lower esophagus. The ruptured esophageal wall was directly closed by the layer to layer method and reinforced with fundic patch by Thal-Hatafuku. The post-operative course was uneventful and the patient was discharged on the 46th day after operation. This surgical procedure was very useful in the patient. We reviewed 59 cases, including our case, which occurred recently in Japan.
由于食管自发性破裂的病例极为罕见，且该病的早期症状与胸腹部急症相似，因此诊断和治疗常常延误，在某些情况下会导致不良后果。一名49岁男性在饮酒后出现严重胸痛和呕吐后呕血。由于该患者被诊断为食管自发性破裂，遂被转诊至我院，并在发病25小时后接受了手术。食管下段左壁有一个3厘米的垂直穿孔。破裂的食管壁采用分层法直接缝合，并采用Thal-Hatafuku胃底补片加固。术后过程顺利，患者在术后第46天出院。该手术方法对该患者非常有效。我们回顾了包括我们的病例在内的59例近期在日本发生的病例。
