Nehra D, Beynon J, Pye J K
Department of Surgery, Maelor General Hospital, Wrexham, Clwyd, UK.
Postgrad Med J. 1993 Mar;69(809):214-6. doi: 10.1136/pgmj.69.809.214.
Five cases of spontaneous rupture of the oesophagus are reported. All cases had surgery within 12 hours, and all survived, illustrating the value of early diagnosis in this rare condition. None had their diagnosis made before admission to the hospital. Myocardial infarction is the commonest misdiagnosis and frequently results in delayed treatment. We believe that a simple direct question to enquire of the patient whether or not vomiting preceded the onset of the severe pain would significantly reduce the rate of misdiagnosis.
本文报告了5例食管自发性破裂的病例。所有病例均在12小时内接受了手术，且全部存活，这说明了早期诊断在这种罕见疾病中的价值。所有病例在入院前均未得到诊断。心肌梗死是最常见的误诊疾病，常常导致治疗延误。我们认为，直接简单地询问患者在剧烈疼痛发作之前是否有呕吐症状，将显著降低误诊率。
