Hopkins 24/7

Back to ABC News

This Thursday at 10/9c

This content requires javascript and flash player version 8.

Johns Hopkins Symptoms and Remedies

Johns Hopkins Medicine

Close Article Browser

Esophageal Rupture

What is it?

An esophageal rupture is a tear in the esophagus, the passageway from the throat to the stomach. It is a medical emergency, requiring prompt diagnosis and treatment. The esophagus may be ruptured by forceful vomiting, chemical injury, trauma, or other disorders of the esophagus, such as esophageal cancer (see Esophageal Cancer for more information). Chest pain from a large tear in the esophagus may mimic symptoms of a heart attack (see Heart Attack for symptom information). Leakage of esophageal contents such as saliva, food, or vomit into the neighboring chest cavity can cause chemical injury or a serious bacterial infection or abscess. Treatment usually involves surgery to repair the tear and remove esophageal contents from the chest cavity, combined with antibiotics to prevent or treat a bacterial infection. If the esophagus has been severely damaged, surgical removal of part or all of the esophagus may be necessary.

What Causes It?

  • Forceful vomiting.
  • Ingestion of a foreign object.
  • Ingestion of lye or other corrosive chemicals (see Esophageal Stricture for more information).
  • Infection, ulcer, or cancer of the esophagus.
  • Trauma, such as an automobile accident.
  • Accidental injury from insertion of tubes or instruments into the esophagus during medical procedures. (Approximately half of esophageal ruptures are caused this way.)

Prevention

  • Keep small objects and household chemicals that may be swallowed away from young children.
  • Obtain prompt treatment for disorders that cause severe nausea and vomiting.

Diagnosis

  • Chest x-ray. You may be required to swallow a contrast material during an x-ray, so that the site of rupture in the esophagus can be clearly identified.

How to Treat It

  • Surgical repair of the rupture is necessary for all but relatively small tears. In cases of severe esophageal damage, the affected portion of the esophagus may be removed surgically.
  • Small tears can often be treated medically. In such cases, the patient will not be permitted to eat and oral suction may be used to keep the esophagus empty.
  • Intravenous fluids and nutrients may be administered to maintain hydration and nutrition until the tear has healed.
  • Intravenous antibiotics may be administered to treat or prevent an associated bacterial infection.

When to Call a Doctor

  • EMERGENCY Call an ambulance for any severe chest pain. Heart attack, esophageal tear, and other serious disorders will need to be ruled out.