Spontaneous oesophageal perforation as a complication of vomiting in gastroenteritis -- case report.
This is a case report of oesophageal perforation as the complication of a commonly encountered benign disease -- gastroenteritis. A 68-year-old man first presented to the Emergency Department complaining of watery diarrhoea. He was treated and discharged. He re-attended 5 h later complaining of epigastric pain radiating to his back, vomiting bloodstained fluid and persistent watery diarrhoea. Again, he was treated and discharged. He re-attended 3 days later complaining of anorexia, cough, dyspnoea and right-sided chest pain radiating to his back, and subjective weight loss in the previous few days. Chest X-ray revealed right pleural effusion, pneumomediastinum and subcutaneous emphysema in the supraclavicular fossae. Computed chest tomogram and water-soluble contrast swallow confirmed 'spontaneous' oesophageal perforation. Although rare, this entity must be considered in any acutely ill patient complaining of respiratory and gastrointestinal symptoms, especially after recent vomiting.
Chung
Chin Hung
CH
Accident and Emergency Department, North District Hospital, Hong Kong, Peoples' Republic of China. chung@ha.org.hk
D000208:Acute Disease; D000368:Aged; D004636:Emergency Service, Hospital; D004939:Esophageal Perforation / Q000175:diagnosis* / Q000209:etiology; D005759:Gastroenteritis / Q000150:complications*; D006801:Humans; D008297:Male; D012422:Rupture, Spontaneous; D013577:Syndrome; D013997:Time Factors; D014839:Vomiting / Q000150:complications*