Treatment of and the Intra-thoracic Drainage Method for Spontaneous Esophageal Rupture

DOI 9 Citations 29 References

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  • 特発性食道破裂の治療方針と胸腔ドレナージ法に関する臨床的検討

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Abstract

We report herein a review of our 19 patients with spontaneous rupture of the esophagus, which include 14 of the extra-mediastinal rupture type and 5 of the intra-mediastinal rupture type. We clinically analyzed the cases in reference to the diagnosis and the treatment. Most patients complained of chest pain after vomiting, which required an early appropriate diagnosis. Emergency operations for the extra-mediastinal rupture type and conservative treatment for the intra-mediastinal rupture type achieved satisfactory results. The procedure consisted of closure of the perforation site with left thoracotomy and gastric fundic patch via the transhiatal approach. To prevent post-operative empyema and mediastinal abscess formation, insertion of a conventional thoracic drainage tube and another fixed drainage tube from the posterior diaphragm to the lateral border of the vertebral column along the thoracic descending aorta seemed effective. The patients underwent continuous irrigation and suction via these drainage tubes.

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