A Case of Spontaneous Esophageal Perforation Complicated with a Bronchial Asthma Attack

DOI 15 References
  • Yamachika Daisuke
    Department of Gastroenterological Surgery, Tokai University, School of Medicine
  • Nishi Takayuki
    Department of Gastroenterological Surgery, Tokai University, School of Medicine
  • Yamamoto Soichirou
    Department of Gastroenterological Surgery, Tokai University, School of Medicine
  • Hara Tadashi
    Department of Gastroenterological Surgery, Tokai University, School of Medicine
  • Hanashi Tomoko
    Department of Gastroenterological Surgery, Tokai University, School of Medicine
  • Chino Osamu
    Department of Gastroenterological Surgery, Tokai University, School of Medicine
  • Shimada Hideo
    Department of Gastroenterological Surgery, Tokai University, School of Medicine
  • Makuuchi Hiroyasu
    Department of Gastroenterological Surgery, Tokai University, School of Medicine

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  • 気管支喘息発作を併発した特発性食道破裂の1例

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Abstract

We present the case of a 43-year-old woman who was on inhaled steroids and oral Uniphyl and Singulair for bronchial asthma treatment. She had been suffering from nausea and vomiting since mid-January. One morning in late January immediately after vomiting, she developed back pain and dyspnea, and was transported to a nearby clinic. The patient was then referred to our hospital for suspected spontaneous esophageal perforation. Upon admission, the patient was having asthma with severe wheezing. Computed tomography demonstrated emphysema in the area between the cervix and the lower mediastinum, and a left-sided pleural effusion. An upper gastrointestinal series confirmed contact medium leakage from the left side of the lower esophagus. Since the leakage did not spread into the thorax, the patient was diagnosed as having an intramediastinal esophageal rupture. Although conservative therapy was considered, there was concern regarding infection exacerbation related to the steroid administration, hence surgery was elected which included a left thoracotomy, irrigation and drainage of the mediastinum and thorax, suture closure of the perforation and suture fixation of the gastric fundus. Since the asthma was controlled with steroids and no sign of anastomotic leakage was detected following surgery, the patient was discharged from the hospital 16 days postoperation.

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