Spontaneous Esophageal Rupture With Bronchiectasis: A Case Report And Review

Object: To present a case of spontaneous esophageal rupture with a history of bronchiectasis and to review the literature of this disease so as to achieve the goal of early and accurate diagnosis and treatment. Method: A patient with spontaneous esophageal rupture admitted to the Intensive Care Unit of the 2nd affiliated hospital of Zhejiang University, College of Medicine was described and the pathogenesis, clinical features, diagnosis and treatment of were analyzed. Result: Spontaneous esophageal rupture is non-traumatic perforation of the esophageal wall. Due to the low incidence and atypical clinical features, it is rarely reported and may easily be misdiagnosed. Delayed treatment may resulted in high mortality rate. A contrast esophageal chest X-ray or chest computerized tomography with a swallow of a water soluble contrast agent is useful and oesophagoscopy is often helpful in diagnosis. Time from perforation occurrence to the establishment of diagnosis and treatment is crucial, and an appropriate surgery and efficient medical treatment are of both importance. The patient had a long history of bronchiectasis which led to the misdiagnosis and delayed surgical treatment. Retrospectively, together with the history, clinical symptoms, the food fragment in the thoracic drainage and the oesophagoscopy report the diagnosis was confirmed. Conclusion: Because of the low incidence and atypical clinical features, spontaneous esophageal rupture is hard to be thought of. A careful study of the history and clinical examination and close observation are important. Oesophagoscopy maybe helpful in confirming the diagnosis. Surgery is important as well as internal treatment.