A Case of Spontaneous Esophageal Rupture of Old age successfully managed by Pedicled Omental Covering

Satoshi Hayama^{1) 2)}, Takayuki Morita¹⁾, Miyoshi Fujita¹⁾, Naoto Senmaru¹⁾, Yuji Miyasaka¹⁾ and Hiroyuki Kato²⁾

¹⁾Department of Surgery, Hokkaido Gastroenterology Hospital, ²⁾Division of Cancer Medicine, Cancer Medicine, Surgical Oncology,
Hokkaido University Graduate School of Medicine

Spontaneous esophageal rupture is rare in old age. We treated such a rupture successfully managed by suturing of the ruptured site and reinforcement by pedicled omental covering. A 75-year-old man seen by local physician reported vomiting, followed by chest pain, dyspnea, and abdominal pain after an episode of drinking. No signs of abnormality were seen in electrocardiography or echocardiography, so he was referred to our hospital with suspected acute abdomen. Upper gastrointestinal scopy showed rupture in the lower esophagus. Under a diagnosis of spontaneous esophageal rupture, we conducted emergency surgery 21 hours after symptom onset. After thoracotomy and laparotomy with an incision of the diaphragm, the esophageal rupture was sutured and the site reinforced with a pedicled omental covering to prevent suture failure. No suture failure or stenosis of the sutured site was seen postoperatively. The man was discharged 23 days after surgery. For spontaneous esophageal rupture, we found the pedicled omental covering procedure useful for reinforcing sutures.

Key words
spontaneous esophageal rupture, pedicled omental covering procedure, old age

Reprint requests
Satoshi Hayama Division of Cancer Medicine, Cancer Medicine, Surgical Oncology, Hokkaido University Graduate School of Medicine Kita 14-jo Nishi 5-chome, Kita-ku, Sapporo, 060-8638 JAPAN

Accepted
November 27, 2001

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