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Overview of Injuries of the Esophagus

by Michael C. DiMarino, MD

The esophagus is relatively impervious to injury but can be harmed gradually by backflow of acid from the stomach (gastroesophageal reflux or GERD—see Gastroesophageal Reflux (GERD)). The esophagus may also be harmed suddenly by caustic or acidic chemicals (see Erosive Esophagitis), irritating drugs, a sharp object, or extreme pressure. Extreme pressure can occur during violent vomiting, and violent vomiting can cause tears in the esophagus (see Esophageal Laceration (Mallory-Weiss Syndrome) and see Esophageal Ruptures).

Sudden injuries can cause pain, often felt as sharp pain under the breastbone. They may also cause bleeding, which would be evident in vomited material or stool. Fainting may occur due to this pain, especially if the esophagus ruptures. This rupture allows food contents to spill into the mediastinum (the area of the chest bordered by the sternum in front, the spinal column in back, the entrance to the chest cavity above, and the diaphragm below) and causes mediastinitis.

Doctors use various methods to diagnose injuries of the esophagus. Methods include esophagoscopy and different types of x-rays.

Treatment depends on the cause of the injury.