TWO CASES OF SPONTANEOUS RUPTURE OF THE ESOPHAGUS TREATED BY PRIMARY SUTURE USING THE COVERING METHOD

Two cases of spontaneous rupture of the esophagus, which were successfully treated by primary suture using the covering method, are reported. Case 1 was a 41-year-old man admitted to the hospital because of chest pain after vomiting on a sight seeing bus. About 10 hours after admission, pleural effusion was noted by a chest x-p film. Esophagography revealed leakage in the lower portion of the esophagus. Emergency surgery was performed. After the esophageal rupture was sutured, the site was covered with a gastric fundic patch. He was discharged from the hospital on the 39th postoperative day. Case 2 was a 26-year-old man referred to the hospital by a local practitioner. The patient complained of epigastralgia after vomiting in a ferry boat. Four hours after admission, a chest x-p film revealed pneumothorax and pneumomediastinum.A diagnosis of spontaneous esphageal rupture was made by esophagography. Emergency surgery was performed. After the ruptured was sutured, the site was covered with a pericardial pedicle flap. Although a minor suture failure occurred, conservative treatment was successful. He was discharged on the 77th postoperative day. In early diagnosed cases of spontaneous esophageal rupture like these cases, a primary covered suture is useful.