Esophageal Tear: Causes, Symptoms, Treatment

An Esophageal Tear is a pathological condition in which there is a rupture of the esophagus through which food passes from the mouth to the stomach. Any sort of rupture or tear in the esophagus may result in serious complications and hence should be taken as a medical emergency and treated accordingly.

There may be many causes for Esophageal Tear, which includes forceful vomiting which may irritate the lining of the esophagus so much that it ruptures, exposure or inhalation of certain chemicals, direct trauma to the esophagus such as a gunshot or a stab wound, and more serious medical conditions like an esophageal cancer. If there is an Esophageal Tear then there will be spillage of food contents, saliva, and vomit into the adjoining chest cavity resulting in serious complications like infection and abscess formation.

The front line treatment of Esophageal Tear is surgery to repair the tear, remove any waste material like vomit or saliva from the chest cavity, and use of antibiotics to treat any infection caused due to Esophageal Tear. If there is significant damage done to the esophagus then complete removal of the esophagus may also be undertaken due to Esophageal Tear.

Some of the causes of Esophageal Tear are:

• Forceful vomiting.
• Ingestion of a foreign object like a blade or any sharp objects that may cause the lining of the esophagus to tear
• Ingestion of corrosive chemicals.
• Esophageal infection.
• Cancer of the esophagus.
• Trauma such as a gunshot or a stab wound to the chest area.
• Certain medical procedures in which there is insertion of tubes or instruments may also cause Esophageal Tear
• Straining while passing bowels.

Some of the symptoms of Esophageal Tear are:

• Moderate to severe chest pain, which tends to get worse with breathing, swallowing, or vomiting.
• Fever.
• Breathing difficulties.
• Excessive sweating.
• Abdominal or back pain.
• Dysphagia.
• Hemoptysis in some cases.
• Hypotension.
• Increased heart rate.

To begin with the treating physician will take a detailed history of the patient inquiring about the onset of symptoms and the severity of it. If a problem with the esophagus is suspected then a chest x-ray may be ordered. An endoscopy may also be performed to explore the inner structures of the esophagus to check whether there is a tear or not. A barium swallow test may be performed, in which the patient will be asked to swallow a contrast material which is usually barium and its path is observed through a monitor. This will clearly pinpoint the location of the tear and confirm the diagnosis of Esophageal Tear.

As stated above, the most preferred and recommended treatment for Esophageal Tear is surgery. In cases where the esophagus is severely damaged beyond repair then partial or complete removal of the esophagus is done to prevent further complications. In cases where there is a mild rupture of the esophagus then abstaining from eating or drinking anything by mouth is recommended to allow healing of the Esophageal Tear.

Till the Esophageal Tear has healed, nutrition is administered through IV fluids or through an NG tube. If there is an infection developing due to Esophageal Tear then antibiotics are administered intravenously to treat such infections. In cases if fluid has developed in the lungs due to Esophageal Tear then draining of the fluid from the lungs is done through a chest tube. Since all of these treatments are quite complex procedures hence it is recommended to diagnose and treat Esophageal Tear as early as possible.

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