Avtor/Urednik		Rupnik, Erik; Kariž, Stojan; Ambrožič, Jana
Naslov		Spontana perforacija požiralnika
Prevedeni naslov		Spontaneous esophageal perforation
Tip		članek
Vir		In: Bručan A, Gričar M, Vajd R, editors. Urgentna medicina: izbrana poglavja 8. Zbornik 9. mednarodni simpozij o urgentni medicini; 2002 jun 19-22; Portorož. Ljubljana: Slovensko združenje za urgentno medicino,
Leto izdaje		2002
Obseg		str. 160-3
Jezik		slo
Abstrakt		Spontaneous esophageal perforation (Boerhaave's syndrome) is a rare entity with characteristic trias: vomiting followed by severe retrosternal or upper abdominal pain, and subcutaneous emphysema. Clinical presentation is often nonspecific and variable and may therefore considerably delay accurate recognition. Diagnosis is usually established by contrast radiography. Mortality is high even with early operative treatment. We report a case of spontaneous esophageal perforation with atypical clinical presentation. A 77 year old female was admitted to our hospital because of suspected acute pancreatitis. She complained of left sided chest and abdominal pain, but denied previous vomiting. A chest radiograph demonstrated a small left pneumothorax and consolidation of the left lower lobe with pleural effusion. Day after admission a large left fluidopneumothorax developed and a chest tube was inserted for drainage. Pleural fluid had characteristics of exudate with high concentration of amylase and low pH. Computed tomography of the chest and upper abdomen with oral contrast and endoscopy of upper gastrointestinal tract were no diagnostic. In spite of clinical improvement after administration of broad-spectrum intravenous antibiotics and symptomatic therapy there was persistent accumulation of left pleural fluid in which food particles were noticed. A water-soluble contrast esophagogram revealed leakage from the esophagus into the left pleural space. The patient was successfully operated and returned to her normal state of health.
Deskriptorji		ESOPHAGEAL PERFORATION AGED