Ruptures can be caused by surgical procedures, severe vomiting, or swallowing a large piece of food that becomes stuck in the esophagus, but some ruptures occur spontaneously.
Symptoms include chest and abdominal pain, fever, and low blood pressure.
Esophageal rupture can be fatal.
The diagnosis is based on the results of x-rays.
Treatment is surgical repair.
Rupture of the esophagus is a very serious condition that is usually caused during endoscopy (examination of the esophagus with a flexible viewing tube) or other procedures in which instruments are inserted through the mouth and throat. Ruptures also may occur during vomiting, retching, or swallowing a large piece of food that becomes stuck in the esophagus. Such rupture is called Boerhaave syndrome. Some ruptures occur spontaneously, especially in people who have untreated eosinophilic esophagitis.
An esophageal rupture allows air, stomach acid, and/or food to leave the esophagus, which causes severe inflammation in the chest (mediastinitis). Fluid may collect around the lungs, a condition called pleural effusion.
To diagnose ruptures of the esophagus, doctors take x-rays of the chest and abdomen.
Doctors confirm the diagnosis by doing esophagography. In this test, doctors take an x-ray or video of the esophagus after the person swallows a liquid (a contrast agent) that makes the lining of the esophagus visible on the x-ray. They must use a special type of contrast agent that does not irritate the chest cavity.
Surgical repair of the esophagus and drainage of the area surrounding it are done immediately. Before surgical repair, doctors give broad-spectrum antibiotics to prevent infection and fluids by vein (intravenously) to treat low blood pressure.
Even with treatment, the risk of death is high.