A Case Of Esophageal Rupture Caused By Long-Term Exposure To
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Esophageal rupture is an emergency for which early diagnosis and treatment interventions determine the prognosis. The treatment of esophageal rupture is selected from multidisciplinary treatments, esophageal resection and reconstruction.

A case of 75-year-old woman who had the habit of drinking vinegar had esophageal rupture due to its long term exposure. She had emergent transport to the hospital because of vomiting and unconsciousness. Her medical history included hypertension, and she took amlodipine 10 mg daily.

On physical examination, she was unconscious, hypotensive and in respiratory failure. Computed tomography of the thoracic and abdomen with contrast showed poor contrast in the middle intrathoracic esophagus, mediastinal emphysema, right pneumothorax and pleural effusion.

The patient underwent emergency surgery for esophageal rupture and septic shock. Intraoperatively, a 25 mm perforated area was found, and the visible esophageal mucosa was black. Because the suture closure or anastomosis was difficult and the shock was prolonged, she was placed in the intensive care unit after undergoing resection of the thoracic esophagus and thoracic drainage.

Fifteen hours after the first surgery, the team performed external esophagostomy and enterostomy. The third surgery was a retrothoracic cervical esophagogastric anastomosis, and reconstructive surgery was performed 60 days after the first surgery.

Prolonged exposure to vinegar may have resulted in esophageal mucosal necrosis. This is a valuable case in which the esophageal mucosa was necrotic, and the team performed esophagectomy and reconstruction as a damage control strategy to save her life.

Source:
https://academic.oup.com/jscr/article/2020/10/rjaa392/5934538
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