Treatment For Ruptured Esophagus: Causes, Symptoms & Diagnosis

The esophagus is the tube-like structure connecting the mouth and stomach. A tear in the tube is known as an esophageal rupture. When there is a rupture in the esophagus, food and / or fluids leak in to the chest and result in severe lung trouble.

The condition is a medical emergency that calls for rapid diagnosis and timely management.

The esophagus may rupture due to swallowing some chemical, powerful vomiting, trauma or a disorder of the esophagus, like malignancy.

Experts say that chest pain from a large tear in the esophagus could even imitate the symptoms of a heart attack. Leakage of the contents of the esophagus, such as saliva, food or vomit in to the chest cavity results in chemical trauma or a very serious bacterial infection.

Surgical intervention is necessary to repair the tear and eliminate the esophageal contents from the chest cavity. Also, antibiotics need to be administered to ward off or treat bacterial infection. In extreme cases, the physician may advise excising a part of or all of esophagus.

What Does A Ruptured Esophagus Feel Like?

Clinical picture of a ruptured esophagus:

  • Mild to severe pain in the chest; the pain aggravates when you breathe or swallow; and especially after vomiting.
  • There may also be pain in the abdomen and / or back.
  • Breathing with great difficulty.
  • Nausea and vomiting. Occasional blood in the vomit.
  • Subcutaneous emphysema
  • Swallowing difficulty
  • Low blood pressure
  • Rapid heart rate
  • Undue sweating
  • Fever

Causes And Diagnosis Of Ruptured Esophagus

Etiological factors for a rupture of the esophagus:

  • Trauma to the esophagus.
  • Tubes or instruments placed in the esophagus during a procedure like endoscopy.
  • Violent and forceful vomiting.
  • Swallowing cleaning fluids, strong chemicals or a foreign object.
  • Lifting a heavy object.
  • Ulcers in the esophagus.
  • Malignant tumor of the esophagus.
  • Straining at stool.

Ruptured Esophagus Diagnosis

Confer with your health care provider about the symptoms and clinical features that you are suffering. He will examine you and may order a few tests to ascertain the cause of the esophageal rupture.

  • Chest x-ray: Helps understand the location and extent of the rupture. You need to swallow a contrast medium so that it is easy to clearly pin-point the place of rupture in the esophagus.
  • Flex esophagoscopy: Helps recognize as well as detect the rupture and establish the degree of trauma and whether it is trans-mural or mucosal.
  • Chest CT: Helps detect esophageal malignancy or abscess.

Treatment For Ruptured Esophagus

  • Surgery to repair the esophageal rupture is necessary for all tears, except the comparatively smaller ones. In cases of severe damage to the esophagus, the afflicted segment of the esophagus may need to be removed surgically.
  • Small tears are sometimes treated medically. The patient will not be allowed to eat anything and oral suction will be done to keep the esophagus empty. Fluids and nutrients will be administered intravenously to sustain adequate hydration and nutrition till the rupture has healed.
  • IV antibiotics are necessary to treat or prevent infection.
  • In case any fluid has collected around the lungs, a chest tube is used to drain the fluid.
  • In case any fluid has accumulated behind the sternum and between the lungs, a mediastinoscopy will be carried out to manage the case successfully.

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