.17 Cases Of Spontaneous Rupture Of The Esophagus Clinical Analysis

Object:To present 17 cases of spontaneous esophageal rupture after treatment of patients, and to review literature on the incidence of the disease profile, pathogenesis, clinical manifestations, so as to achieve the goal of early and accurate diagnosis and treatment.Methods:From March 2003 to December 2009,17 patients of spontaneous esophageal rupture were treated with clinical data. The diagnosis, treatment and outcome of the patients were analyzed retrospectively.Results: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.3 cases were misdiagnosed, surgical treatment in 12 cases,12 patient were cured and 0 was died; conservative therapy with close drainage of thoracic cavity and nutritional support in 5 cases,4 cases were cured,1 was deaths.Conclusion:1. Spontaneous esophageal rupture is a rare emergency thoracic disease, Early diagnosis and early surgical treatment are an effective way to reduce mortality.2. After the diagnosis, surgical repair should be the first choice. The length of time of esophageal rupture is not the sole criterion for surgical repair. Early diagnosis and timely surgery treatment can improve efficacy and reduce mortality.3. Serious infection is not a contraindication of surgery. After clear mediastinal infection, symptoms can be improved.4. If diagnosis is late, rupture length is small and signs of infection are mild, conservative treatment can be used.