Most common site of spontaneous rupture of esophagus is?
Correct Answer: Cardio esophageal junction
Description: Cardio esophageal junction REF: With text "Spontaneous rupture of the esophagus is probably related to the violent pressure excursions which occur at the cardioesophageal junction during emesis" REF: Cole and Zollinger textbook of surgery 9th edition page 719 "Spontaneous rupture almost always occurs on the left side of the distal third of the oesophagus" REF: Mastery of surgery: Volume 1 by Josef E. Fischer, K. I. Bland Page 789 "Spontaneous rupture is the second most common cause of oesophageal perforation. The most common site of spontaneous perforation is the left lateral wall of the distal oesophagus because of relative weakness of wall in this region" REF: The Esophagus byJoel E. Richter, Donald 0. Castell Page 759 Spontaneous rupture of the esophagus is associated with a high moality rate because of the delay in recognition and treatment. Although there usually is a history of resisting vomiting, in a small number of patients, the injury occurs silently, without any antecedent history. When the chest radiogram of a patient with an esophageal perforation shows air or an effusion in the pleural space, the condition is often misdiagnosed as a pneumothorax or pancreatitis. An elevated serum amylase caused by the extrusion of saliva through the perforation may fix the diagnosis of pancreatitis in the mind of an unwary physician. If the chest radiogram is normal, a mistaken diagnosis of myocardial infarction or dissecting aneurysm is often made. REF: Schwaz's Principles of Surgery 9th edition Chapter 25 Esophagus and Diaphragmatic Hernia
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