SURGICAL-MANAGEMENT OF INTRATHORACIC ESOPHAGEAL RUPTURE

Intrathoracic oesophageal rupture is a life-threatening condition that requires early diagnosis and effective treatment if death or serious prolonged illness is to be avoided. Six consecutive patients with intr athoracic oesophageal rupture were treated by debridement and irrigati on of the mediastinum and primary suture closure with reinforcement of the suture line by pedicled omentum. The cause of the rupture was Boe rhaave's syndrome in five patients and compressed air injury to the oe sophagus in one. All but one patient presented more than 24 h after on set of symptoms, with a mean of 38 (range 12-72) h. All the patients r ecovered well with no postoperative oesophageal leakage. The mean hosp ital stay was 11.5 (range 9-15) days. Irrespective of the duration of the oesophageal rupture, aggressive resuscitation and prompt primary s uture closure with reinforcement of the suture line with a well vascul arized pedicled tissue flap is required for optimal results.