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Spontaneous intramural rupture of the esophagus: Clinical presentation and endoscopic findings

2002; Elsevier BV; Volume: 56; Issue: 1 Linguagem: Inglês

10.1067/mge.2002.125360

1097-6779

Michael Glück, Geoffrey C. Jiranek, Donald E. Low, Richard A. Kozarek,

Esophageal Cancer Research and Treatment

Laceration of the esophagus occurs most frequently at the gastroesophageal junction and is a common cause of GI bleeding. Referred to as Mallory-Weiss tears, this mucosal laceration usually arises as a result of vigorous coughing, vomiting, or rapid increases in intra-abdominal pressure. Deeper injury involving the muscularis propria can lead to perforation of the esophagus, also known as Boerhaave's syndrome. 1 Faigel DO Fennerty MB. Miscellaneous diseases of the esophagus. in: 3rd ed. Textbook of gastroenterology. Lippincott Willams Wilkins, Philadelphia1999: 1311-1314 Google Scholar Spontaneous intramural esophageal rupture (SIER), or incomplete perforation, is a deeper injury than the Mallory-Weiss tear but it does not extend through the entire muscle layer as in Boerhaave's syndrome. SIER tends to be long and deep and is located proximal to the gastroesophageal junction. 2 Younes Z Johnson DA. The spectrum of spontaneous and iatrogenic esophageal injury: perforations, Mallory-Weiss tears, and hematomas. J Clin Gastroenterol. 1999; 29: 306-317 Crossref PubMed Scopus (104) Google Scholar , 3 Steadman C Kerlin P Crimmins F Bell J Robinson D Dorrington L et al. Spontaneous intramural rupture of the oesophagus. Gut. 1990; 31: 845-849 Crossref PubMed Scopus (61) Google Scholar Three patients during the last 4 years have presented to our institution with deep, long esophageal muscular lacerations characteristic of SIER. Their clinical presentation, endoscopic findings, and subsequent course are discussed.