食道癌に合併した特発性食道破裂の１例

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  • A Case of Spontaneous Esophageal Rupture Complicated with Esophageal Cancer.

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A 66-year-old man was emergently admitted to the hospital because of severe chest pain and cold sweat suddenly occurred after taking a breakfast. Chest CT scan and an esophagography disclosed an intrathoratic esophageal tumor and esophageal rupture at the distal site of the esophageal tumor. Left thoracotomy revealed a perforation of the lower thoracic esophagus, approximately 3.5cm in length. Operative procedures included an intrathoratic drainage, primary closure of the esophageal perforation and a gastrostomy. After the operation, endotoxin absorption therapy and respiratory support were necessary due to septic shock and respiratory distress. Postoperative esophagography from the gastrostomy revealed gastro-esophageal reflex. Esohageal cancer might cause high pressure in the lower part of esophagus and result in the rupture. We often encounter clinical case reports of spontaneous esophageal rupture, but there have been few reports of the disease associated with esophageal cancer so far. This case is thought to be rare.

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