摘要
自發性食道破裂，在臨床上是一罕見的致命性疾病，不易早期診斷或常被誤診。典型症狀多在一陣強烈嘔吐後，發生胸部或腹部劇痛。而胃內容物進入縱膈腔、肋膜腔後，造成的發炎反應及細菌感染，令罹病率和死亡率都隨著診斷的延遲而快速升高。因此影響預後最重要的因素就是早期診斷並及早治療。縱膈腔氣腫、縱膈腔炎、氣胸、氣胸、水氣胸等是常見的併發症。敗血性休克和心肺衰竭是主要致死原因。我們報告一位53歲的女性病人，因腹部不適，在家自行催吐，產生劇烈胸痛至本院求診。在排除其他急症後的同時，我們初步臆測為食道破裂，立即安排胸部電腦斷層和食道X光造影檢查，見到食道破裂及顯影劑外漏，於最短的時間內確立了本症的診斷。
並列摘要
Spontaneous rupture of the esophagus is a rare but life-threatening condition. Diagnosis is often delayed because the symptoms can mimic many other clinical disorders. The classic history is of a patient who vomits and experiences substemal or epigastric pain. As gastric content passes to mediastinum and pleural space, a delay in diagnosis raises morbidity and mortality significantly. Early diagnosis and prompt surgical repair are critical forsurvival. Pneumomediastinum, mediastinitis, empyema, pneumothorax and hydropneumothorax are common complications. Septic shock and cardiopulmonary failure are the major causes of death. We report a case of typical spontaneous rupture of the esophagus in a 53-year-old woman who developed severe chest pain after an episode of self-induced vomiting. After ruling out other common emergencies, we thought of the possibility of spontaneous rupture of the esophagus. Chest CT scan and water soluble contrast esophagography were arranged immediately. The studies showed the esophageal perforation and extravasation of contrast medium, which established the diagnosis of spontaneous rupture of the esophagus within the shortest time. The patient received surgical intervention and recovered smoothly.