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Spontaneous oesophageal rupture: a diagnostic challenge in resource-limited setting.

Shao ER, Joseph PM, Slootweg P, Mkwizu EW, Kilonzo KG, Mwasamwaja AO - Oxf Med Case Reports (2015)

Bottom Line: In resource-limited settings, it is very challenging to diagnose this condition especially when its presentation is atypical.Its prognosis is very poor when diagnosis is delayed due to risk of mediastinitis.Water-seal drainage was established gushing 1200 ml of food materials.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Internal Medicine , Kilimanjaro Christian Medical Center , Moshi , Tanzania ; Kilimanjaro Christian Medical University College , Moshi , Tanzania ; Image Doctors International , Arusha , Tanzania ; Better Human Health Foundation , Moshi , Tanzania.

ABSTRACT
Spontaneous oesophageal rupture after swallowing a bolus of food is a very rare condition. In resource-limited settings, it is very challenging to diagnose this condition especially when its presentation is atypical. Its prognosis is very poor when diagnosis is delayed due to risk of mediastinitis. We report a case of 37-year-old man who was admitted to our hospital complaining of sudden onset of chest tightness and pain after a meal 8 h prior to admission. Urgent chest radiograph revealed right hydropneumothorax with collapsed lung. Water-seal drainage was established gushing 1200 ml of food materials. Definitive diagnosis of oesophageal rupture was reached after post-mortem.

No MeSH data available.


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Collapsed right lung and hydropneumothorax (arrow).
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OMV048F1: Collapsed right lung and hydropneumothorax (arrow).

Mentions: On arrival at our emergency room, the patient was critically ill, dyspnoeic with an SaO2 of 60% in room air and 90% on 4 l of oxygen by nasal catheter. Chest radiograph revealed a right hydropneumothorax with collapsed lung, air in the pleural cavity, pleural effusion, mediastinum shift to the left and infiltrates in the left lung (Fig. 1). Water-seal drainage was inserted by surgeons, which yielded air together with 1200 ml of food material. Patient was started on broad spectrum intravenous antibiotics within the first 8 h.Figure 1:


Spontaneous oesophageal rupture: a diagnostic challenge in resource-limited setting.

Shao ER, Joseph PM, Slootweg P, Mkwizu EW, Kilonzo KG, Mwasamwaja AO - Oxf Med Case Reports (2015)

Collapsed right lung and hydropneumothorax (arrow).
© Copyright Policy - creative-commons
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4584513&req=5

OMV048F1: Collapsed right lung and hydropneumothorax (arrow).
Mentions: On arrival at our emergency room, the patient was critically ill, dyspnoeic with an SaO2 of 60% in room air and 90% on 4 l of oxygen by nasal catheter. Chest radiograph revealed a right hydropneumothorax with collapsed lung, air in the pleural cavity, pleural effusion, mediastinum shift to the left and infiltrates in the left lung (Fig. 1). Water-seal drainage was inserted by surgeons, which yielded air together with 1200 ml of food material. Patient was started on broad spectrum intravenous antibiotics within the first 8 h.Figure 1:

Bottom Line: In resource-limited settings, it is very challenging to diagnose this condition especially when its presentation is atypical.Its prognosis is very poor when diagnosis is delayed due to risk of mediastinitis.Water-seal drainage was established gushing 1200 ml of food materials.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Internal Medicine , Kilimanjaro Christian Medical Center , Moshi , Tanzania ; Kilimanjaro Christian Medical University College , Moshi , Tanzania ; Image Doctors International , Arusha , Tanzania ; Better Human Health Foundation , Moshi , Tanzania.

ABSTRACT
Spontaneous oesophageal rupture after swallowing a bolus of food is a very rare condition. In resource-limited settings, it is very challenging to diagnose this condition especially when its presentation is atypical. Its prognosis is very poor when diagnosis is delayed due to risk of mediastinitis. We report a case of 37-year-old man who was admitted to our hospital complaining of sudden onset of chest tightness and pain after a meal 8 h prior to admission. Urgent chest radiograph revealed right hydropneumothorax with collapsed lung. Water-seal drainage was established gushing 1200 ml of food materials. Definitive diagnosis of oesophageal rupture was reached after post-mortem.

No MeSH data available.


Related in: MedlinePlus