title: Spontaneous rupture of the esophagus with extensive bowel necrosis caused by nonocclusive mesenteric ischemia: report of a case.
abstract: We report a case of spontaneous rupture of the esophagus accompanied by extensive bowel necrosis caused by nonocclusive mesenteric ischemia. The patient was treated successfully with prompt surgical intervention after an early diagnosis. A 61-year-old man was admitted to our hospital complaining of abdominal pain after drinking. On arrival, he was suffering shock. Thoracoabdominal computed tomography and esophagoscopy findings were highly suggestive of rupture of the esophagus above the esophagogastric junction and extensive bowel necrosis. Emergency laparotomy revealed extensive bowel necrosis from the jejunum to the transverse colon; thus, we resected the entire affected region and performed jejunostomy and transverse colostomy. After suturing the esophageal perforation directly, we performed intramediastinal packing of the omentum and inserted drains. The patient recovered well and was discharged from hospital on postoperative day 126. To the best of our knowledge, this is the first case report of spontaneous rupture of the esophagus with nonocclusive mesenteric ischemia.
authors.affiliation: Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto, 602-8566, Japan.
authors.forename: Shingo
authors.initials: S
authors.lastname: Nakashima
authors.forename: Atsushi
authors.initials: A
authors.lastname: Shiozaki
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Fujiwara
authors.forename: Yasutoshi
authors.initials: Y
authors.lastname: Murayama
authors.forename: Shuhei
authors.initials: S
authors.lastname: Komatsu
authors.forename: Hisashi
authors.initials: H
authors.lastname: Ikoma
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Kuriu
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Nakanishi
authors.forename: Daisuke
authors.initials: D
authors.lastname: Ichikawa
authors.forename: Kazuma
authors.initials: K
authors.lastname: Okamoto
authors.forename: Toshiya
authors.initials: T
authors.lastname: Ochiai
authors.forename: Yukihito
authors.initials: Y
authors.lastname: Kokuba
authors.forename: Eigo
authors.initials: E
authors.lastname: Otsuji
mesh_terms: D015746:Abdominal Pain / Q000175:diagnosis / Q000209:etiology; D003106:Colon / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D004322:Drainage / Q000379:methods; D004630:Emergencies; D004935:Esophageal Diseases / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery*; D004945:Esophagoscopy / Q000379:methods; D005500:Follow-Up Studies; D006801:Humans; D007511:Ischemia / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D007583:Jejunum / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D007813:Laparotomy / Q000379:methods; D008297:Male; D065666:Mesenteric Ischemia; D008875:Middle Aged; D009336:Necrosis / Q000150:complications / Q000473:pathology; D011859:Radiography; D035583:Rare Diseases; D018570:Risk Assessment; D012422:Rupture, Spontaneous / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery; D013536:Suture Techniques; D016896:Treatment Outcome; D014652:Vascular Diseases / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*