Rupture of the Esophagus in the Neonate

‘Spontaneous’ rupture of the healthy oesophagus

“…Studies on cadavers, with retrograde injection of contrast media under pressure from the stomach, have confirmed this region to be the weakest part of the oesophageal wall (Bodi, Fanger & Forsythe, 1954). It is of interest to note that spontaneous oesophageal rupture which occurred in five neonates was always into the right pleural cavity (Hohf, Kimball & Bellenger, 1962), this presumably being related to the fact that in babies the distal oesophagus is situated more to the right than in the adult, with the aorta protecting its left side. Small & Ellis (1958) have drawn attention to the similarities between spontaneous rupture of the oesophagus and the syndrome of post-emetic bleeding from gastric mucosal tears (Mallory & Weiss, 1929).…”

Spontaneous rupture of the esophagus in the newborn

“…Early non-specific respiratory disorders are the outstanding feature of the clinical picture. Hematemesis is unusual [6,8,11,14]. The main radiological symptom is a right pleural effusion, usually with hydropneumothorax, or pneumothorax.…”

“…The diagnosis is sometimes made by the digestive origin of the fluid produced by pleural aspiration [6,7,10,[12][13][14][15]. However, oral feeding may have been stopped so analysis of the effusion may not be diagnostic (case 1).…”