Rupture of Abdominal Esophagus Suspected being caused by Femoral Hernia Incarceration; A Case Report

Takahisa Hirokawa, Yoshimi Akamo, Takehiro Wakasugi, Minoru Yamamoto, Hirozumi Sawai, Yuji Okada, Hiromitsu Takeyama and Tadao Manabe

Department of Gastroenterological Surgery, Nagoya City University, Graduate School of Medical Sciences

Spontaneous esophagus rupture, a relatively rare disease usually due to vomiting in over drinking of alcohol, has a dismal prognosis if diagnosis and treatment are delayed. We report a case of spontaneous esophageal rupture suspected being caused by femoral hernia incarceration. An 86-year-old woman seen for emergency hematemesis had a slightly bulging abdomen, but no tenderness or peritonitis. Abdominal X-ray photography showed small amounts of intestinal gas, and abdominal computed tomography (CT) showed right femoral hernia incarceration and small intestinal ileus, with apparent free air seen around the esophagus. We conducted esophagoscopy to diagnose the free air or esophagus lumen after repairing the femoral hernia incarceration, conducting emergency surgery on a diagnosis of spontaneous esophageal rupture, followed by primary closer and fundic patch. The woman was discharged without complications.

Key words
spontaneous rupture of the esophagus (Boerhaave syndrome), femoral hernia incarceration, ileus

Reprint requests
Takahisa Hirokawa Department of Gastroenterological Surgery, Nagoya City University, Graduate School of Medical Sciences
1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, 467-8601 JAPAN

Accepted
June 28, 2006

To read the PDF file you will need Abobe Reader installed on your computer.