Spontaneous esophageal rupture responding to simple suture closure, drainage, and percutaneous endoscopic gastrostomy (PEG): case report

Spontaneous esophageal rupture is a rare disease, and the diagnosis and treatment have not been fully established. Herein we present a 55-year-old man with spontaneous esophageal rupture who was successfully treated using simple suture closure, drainage, and intraoperative percutaneous endoscopic gastrostomy. He was brought to the emergency room after vomiting gastric contents and blood and then experiencing chest pain. On admission, vital signs were normal. Emergency endoscopy was performed for hemostasis, and spontaneous esophageal rupture was diagnosed. As chest computed tomography suggested intrathoracic perforation, surgery was performed about 8 h after onset. Surgery confirmed spontaneous esophageal rupture localized in the mediastinum. Simple suture closure, drainage, and intraoperative endoscopic gastrostomy were performed. On postoperative day (POD) 1, the patient was weaned off artificial ventilation, and enteral feeding through PEG was initiated. Oral intake was restarted on POD 10. The patient was discharged on POD 16.