Summary
Spontaneous intramural oesophageal perforation appears at any level, but preferably
on the posterior wall, and is usually longitudinal. Unlike the Mallory Weiss and the
Boerhaave syndromes, females are more frequently affected. It appears with sudden
retrosternal pain radiating to the epigastrium, neck and back, followed by haematemesis
of small quantity and dysphagia. Vomiting is rare. In contrast to complete rupture,
neither pneumomediastinum nor emphysema is observed, barium swallow being the diagnostic
test of choice whenever this pathology is suspected. However, when the symptoms are
not typical, endoscopy is a useful method for diagnosis. Treatment must be conservative,
while surgery is suggested in the case of recurrent symptoms or big intramural haematomas
with a high risk of perforation. A 74-year-old woman is presented. Endoscopy was performed
as an emergency in suspected food impaction in the oesophagus. This case was diagnosed
as spontaneous intramural oesophageal perforation. The patient also presented with
oesophageal diverticulum and hiatal hernia. Conservative treatment was given, and
the lesion cured.
Key words:
Oesophageal perforation - Dysphagia
