Spontaneous rupture of the oesophagus with unusual features.

SPONTANEOUS rupture of the oesophagus is an uncommon but not a rare condition. Early diagnosis is essential because the patient's only hope for survival lies in early definitive surgery. Even with surgery, the survival rate varies between only 64% (Derbes & Mitchell, 1956) and 73% (Anderson, 1952). Without surgery death is inevitable (Derbes & Mitchell, 1956). The diagnosis is often not difficult, provided the condition is borne in mind, although it has, on occasion, been confused with many other conditions, including perforated peptic ulcer, myocardial infarction, acute pancreatitis, dissecting aneurysm of the aorta, spontaneous pneumothorax and strangulated internal hernia (Ware et al., 1952; Derbes & Mitchell, 1956). We describe here a case of spontaneous rupture of the oesophagus in which some extraordinary features occurred, confusing the diagnosis.