Rupture of the œsophagus associated with lesions of the central nervous system

Spontaneous rupture of the oesophagus with unusual features

“…Sudden discontinuity of the wall of the oesophagus may be a primary ('spontaneous') event, or secondary to some disease process which weakens the wall, such as peptic oesophagitis, malignancy or oesophagomalacia which may, in turn, be secondary to a cerebral lesion (Maciver et al, 1956). Our case is one of spontaneous rupture and conforms to the definition of Mackler (1952) by differing from other forms in two respects: it occurred in a previously healthy organ and, in contrast to the small round hole of a perforation, the rupture appeared as a clean-cut longitudinal rent at or near the oesophago-gastric junction.…”

Traumatic Perforations of the Pharynx and Œsophagus

“…Five cases have occurred in this Hospital during the past 10 years but it is intended these should be reported elsewhere as the otolaryngologist meets them infrequently. Rupture of the oesophagus associated with lesions of the central nervous system has been recorded by Maciver et al (1956). The common factor in spontaneous ruptures and those associated with central nervous system lesions is vomiting.…”

“…In all the cases of spontaneous rupture seen at the Royal Victoria Infirmary the patient had a prolonged history of duodenal ulcer and at first the diagnosis entertained was that of a perforated ulcer. A diagnosis of spontaneous rupture of the oesophagus following a head injury (Maciver et al, 1956) is also likely to be overlooked if the clinician in charge is unaware of this eventuality.…”

Neurogenic Rupture of the Oesophagus

“…Rupture of the oesophagus was found in fifteen out of 452 consecutive autopsies on patients who had died of intracranial lesions in this hospital between 1951 and 1954. It was only found three times in 1,590 other autopsies performed during the same period, twice in patients with acute lesions of the upper part of the spinal cord and once in a patient who had died in hepatic coma (Maclver et al, 1956). Thirteen more cases have occurred during the last three years.…”