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Oesophageal rupture (Clinical presentation (Chest pain (Radiation
Nil,…
Oesophageal rupture
Clinical presentation
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Chest pain
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Associated symptoms
Odonophagia, tachypnoea, dyspnoea,
fever, shock, surgical emphysema
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Diagnosis
Examination
Respiratory
Surgical emphysema
SOB, raised RR
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Investigations
Bedside
Obs (raised HR, RR, low BP, fever)
ECG (tachycardia)
Bloods
FBC, U+E, LFTs,
clotting, G+S, crossmatch,
troponins, amylase
Imaging
CXR - pneumomediastinum,
surgical emphysema,
L pleural effusion, pneumothorax
History
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PMH
Gastro disease, medical conditions,
previous surgery
PC/HPC
Pain (SOCRATES), recent vomiting,
recent endoscopy, ingested FB
FH
Gastro disease, other conditions
SH
Living arrangements, occupation,
alcohol, smoking
Management
Definitive
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Surgical
Serious cases
Debridement of mediastinum
Drainage tube and formation of controlled
oesophageal-cutaneous fistula
Conservative
Information, advice, support
ASAP referral cardiothoracics
NG tube
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Definition
Perforation of the oesophagus,
resulting in air and oesophageal
contents entering the mediastinum