Undiagnosed spontaneous oesophageal rupture presenting as right hydropneumothorax
Spontaneous oesophageal rupture has been a known ailment with a high morbidity and mortality. Various factors contribute to its predisposition such as preexisting oesophageal diseases, increased intraluminal pressure, neurogenic causes, and iatrogenic-commonest being instrumentation. We present the case of a 26-year-old male with features of right hydropneumothorax for which an intercostal chest drain (ICD) was inserted that yielded turbid fluid with suspicion of it being gastric contents. With a diagnosis of diaphragmatic hernia and gut/bowel injury caused due to intercostal drain, the patient underwent emergency exploratory laparotomy. No abnormality was detected and possibility of oesophageal injury/rupture was contemplated though ruled out on investigations. The patient improved with medical treatment of empyema and discharged. The patient was lost to follow-up until after a year the patient reported to surgery OPD with complaints of dysphagia. A barium swallow revealed thoracic oesophageal benign stricture thus confirming our suspicion of spontaneous oesophageal rupture that had occurred a year ago. Knowledge about atypical presentations of oesophageal rupture is important so as to be more aware of this possibility.
KeywordsBoerhaave syndrome Oesophageal perforation Oesophageal stricture
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee. This article does not contain any studies with animals performed by any of the authors.
Informed consent was obtained from the patient included in the study.
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