title: Spontaneous midesophageal rupture.
abstract: Spontaneous rupture of the esophagus is rare. To date, 17 such cases, including our patient, have been reported in the literature. We present a case of true spontaneous rupture that occurred during sleep. Because the correct diagnosis was made 36 h after the rupture, treatment consisted of surgical drainage only. The drainage was extrapleural, though a posterior mediastinal approach, thereby avoiding the complication of empyema. The paraesophageal abscess was repeatedly irrigated with povidone-iodine solution. The patient recovered after a long period--56 days--of hospitalization. The report includes a review of the signs and symptoms of esophageal perforation, the current mode of therapy, and some speculation on the pathogenesis of true spontaneous perforation.
mesh_terms: D004322:Drainage; D004724:Endoscopy; D004935:Esophageal Diseases / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012422:Rupture, Spontaneous