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Spontaneous perforation of cervical oesophagus: a rare variant of Boerhaave's syndrome

Published online by Cambridge University Press:  02 March 2009

S Mittal ,
A Rohatgi ,
R P Sutcliffe  and
A Botha
S Mittal*
Affiliation:
Department of Surgery, St Thomas' Hospital, London, UK
A Rohatgi
Affiliation:
Department of Surgery, St Thomas' Hospital, London, UK
R P Sutcliffe
Affiliation:
Department of Surgery, St Thomas' Hospital, London, UK
A Botha
Affiliation:
Department of Surgery, St Thomas' Hospital, London, UK
*
Address for correspondence: Dr Shruti Mittal, 6 Waterloo Mansions, 59 Webber Street, London SE1 0RD, UK. E-mail: shrut1@hotmail.co.uk
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Abstract

Background:

A 29-year-old man presented with sudden onset of severe pain in his throat, difficulty breathing and a hoarse voice, following an episode of vomiting.

Investigations:

Initial laboratory tests were normal. The patient underwent fibre-optic nasendoscopy, which demonstrated a haematoma in the piriform fossa. Lateral neck radiography and subsequent computed tomography scanning confirmed a 2 cm, loculated, gas-containing collection at the level of the vallecula in the right posterolateral wall, extending to the false vocal folds and communicating between the right parapharyngeal space and the right carotid sheath. Water-soluble contrast swallow confirmed the diagnosis.

Diagnosis:

Contained oesophageal perforation.

Management:

Conservative treatment was adopted involving nil orally, intravenous antibiotics and nasogastric feeding. The patient made an uneventful recovery.

Keywords

OesophagusNeckPerforation

Information

Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 123 , Issue 12 , December 2009 , pp. 1378 - 1380
Copyright
Copyright © JLO (1984) Limited 2009

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