A CASE REPORT OF SPONTANEOUS RUPTURE OF THE ESOPHAGUS CURED BY TRANSABDOMINAL MEDIASTINAL DRAINAGE

A 66-year-old woman who developed spontaneous rupture of the esophagus caused by vomiting after drinking has been successfully cured by transabdominal mediastinal drainage and gastrostomy. Though over 200 cases of the disease had been reported in Japan, it still remains in a severe one in which delayed diagnosis and treatment lead to life-threatening condition. For this disease thoracotorny is usually applied, and a few cases might be cured by only mediastinal drainage like this case. If the rupture occurred at lower part of the esophagus and the pleura mediastinalis was intact, transabdominal approach should be considered as an appropriate procedure. Chest X-ray film and esophagogram are particularly important for diagnosis. Moreover, a factor XIII preparation was effective for postoperative tracheo-esophageal fistula in this case. Some reports, which demonstrated the clinical availability of the preparation in failure of the sutures after primary suture at the ruptured part of the esophagus, also support that active use of the preparation is recommended for cases with declined factor XIII.