The tube which connects the mouth to the stomach is called the esophagus. At times a tear occurs in this tube which is generally known as the esophageal rupture. So, what happens when your esophagus ruptures and what to do about it?

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What Happens When Your Esophagus Ruptures?

What Happens When Your Esophagus Ruptures?

Esophageal rupture can be a serious issue. Let us understand what happens when your esophagus ruptures. When the rupture takes place in the esophagus, it allows the fluid and even the food to enter into the chest which causes serious problems in the lung. The rupture might take place due to forceful vomiting, chemical injury and also due to several other disorders of the esophagus. Esophageal cancer is one of the most dangerous disorders of the esophagus.

When your esophagus ruptures, it is mainly the tear of the wall of the esophagus. The oesophagus is basically a deep hollow tube which moves from the pharynx to the stomach.

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The tear in the esophagus is an extremely grave condition which can also be caused during the process of endoscopy. Endoscopy is a process where the esophagus is examined with the help of a viewing tube.

Apart from endoscopy, esophageal ruptures also take place when instruments are inserted in the mouth and throat. Ruptures are common during retching or even when a person swallows a large piece of food that gets stuck in the esophagus. Certain ruptures take place spontaneously.

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A large tear in the esophagus might cause chest pain which also has the tendency to impersonate the symptoms of a heart attack. Serious bacterial infections are common due to the leakage of the esophageal contents like vomit, food or the saliva into the chest. When you esophagus ruptures, it allows the air, food and stomach acid to leave the esophagus and this causes tremendous inflammation in the chest. Fluids also at times may collect around the lungs and this condition is called pleural effusion.

Such conditions mainly require surgery for the purpose of repairing the tear and to remove the esophageal contents from the chest. It requires a combination of antibiotics too for the prevention of bacterial infection. Surgical removal of certain parts of the esophagus needs to be carried out in case of serious damage.

Symptoms of Esophageal Rupture

Here are some of the most common symptoms which you may experience when your esophagus ruptures. It is necessary to keep the symptoms in mind so that effective and swift measures are taken at the earliest.

  • Severe or moderate chest pain might take place at regular intervals. This might worsen the situation while swallowing and breathing that is followed by either vomiting or retching.
  • Feverish feeling throughout the day. It weakens the body.
  • There can be chances of difficulty in breathing. The process of breathing tends to be shallow or rapid.
  • Sweating excessively and profusely.
  • Abdominal and back pain is a common condition.
  • Vomiting as stated above is a common symptom but vomiting blood is a dangerous symptom.
  • The blood pressure tends to be very low during this time.
  • As against the blood pressure, the heart rate is quite rapid.

When you esophagus ruptures, it is both medical and surgical challenge. The diagnosis of this condition is most often missed and even delayed which results in the increase of mortality and morbidity. Hence, such a condition requires an emergency hospitalization which requires a rapid diagnosis in order to prevent severe morbidity and death.

The constant rupture of the esophagus is also called the Boerhaave’s Syndrome (BS). It has become very common in the present day scenario. The true incidence of it still remains unknown. The mortality range lies between 20-40% with proper and prompt treatment and it is likely to go up to 100% in case the treatment is delayed by more than 48 hours.

Causes of Esophageal Rupture

While it is important to know what happens when your esophagus ruptures, it is also necessary to understand what causes esophageal rupture, to be able to avoid certain mishaps and complications.

  • Vomiting forcefully
  • Ingestion of the various foreign objects along with lye and any other corrosive chemical
  • The chances of the rupture are more when there is infection, ulcer or cancer in the esophagus
  • Trauma and severe injury to the esophagus
  • Accidental injuries are very common because of the insertion of various instruments and injection into the esophagus during the medical procedures. It can be highlighted that more than 90% of the esophageal ruptures take place in this manner.
  • Straining during the process of defecation and lifting heavy objects can also be considered to be a cause.
  • Swallowing of the various cleaning fluids are extremely harmful and can cause esophageal rupture.

Diagnosis of Esophageal Rupture

When a person has an esophageal rupture, immediate medical help is required to make an early diagnosis and begin with the treatment plan.

  • The diagnosis can be confirmed with a Chest x-ray. The patient might have to swallow a material for the clear identification of the site where the rupture has taken place.
  • A flex esophagoscopy can also be used for the identification of the location of the perforation. The doctor might perform it depending on the cause which will help in revealing the size and location of the rupture. It aids in shaping the degree of the injury i.e. transmural or mucosal.
  • A chest CT Scan acts as the best way for the detection of oesophageal cancer or if there is an abscess in the chest.
  • Depending on the symptoms and overall condition, the investigations are planned to confirm the diagnosis of an esophagus rupture.

What To Do About Esophageal Rupture?

Once the diagnosis is confirmed, the correct treatment for esophageal rupture can be planned. A surgical repair of the esophagus and the drainage of the area which surrounds it should be carried out immediately without any delay. It can be put forth that the surgical repair is suitable for relatively small tears. The doctors provide various broad-spectrum antibiotics for the prevention of infection and fluids by vein in order to treat low blood pressure. The ruptures should not only be cleaned but should also be removed by the surgeons. Small or minor tears can be treated medically and during this procedure, the patients are not allowed to eat. In order to keep the esophagus empty, oral suction is used.

The administration of intravenous fluids and nutrients is essential for the maintenance of hydration and nutrition till the time the tear is healed. A chest tube can be used for draining the tube which has collected around the lungs. In case any fluid has been gathered in the breastbone area or between the lungs then a procedure called mediastinoscopy needs to be performed. Intravenous antibiotics are necessary for treating bacterial infection. It is necessary to keep in mind that in spite of effective and timely treatment, the risk of death is quite high in case of esophageal rupture.

Prevention of Esophageal Rupture

It is always a good practice to keep away small objects as well as the household chemicals which might be swallowed by young children. Prompt treatment for the various disorders which cause serious nausea and vomiting should be taken care of to avoid complications like esophageal rupture.

Now that you are aware of what happens when your esophagus ruptures and what to do about it, you can surely seek medical aid and help manage it appropriately.

Sheetal DeCaria MD

Written, Edited or Reviewed By:

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Last Modified On: July 22, 2019

This article does not provide medical advice. See disclaimer

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