Neurogenic rupture of the oesophagus.

IT was in 1849 that Rokitanski noticed the relative frequency with which gastric and oesophageal lesions were found in patients who had died of intracranial disease. Cushing, in 1932, described eleven cases of alimentary tract lesions occurring in association with intracranial disease; two of them had rupture of the oesophagus. Fincher and Swanson (1949) described three cases of neurogenic rupture of ±e oesophagus and concluded that this complication was commoner than had been • generally realized. Rupture of the oesophagus was found in fifteen out of 452 consecutive autopsies on patients who had died of intracranial lesions in this hospital between 1951 and 1954. It was only found three times in 1,590 other autopsies performed during the same period, twice in patients with acute lesions of the upper part of the spinal cord and once in a patient who had died in hepatic coma (Maclver et al., 1956). Thirteen more cases have occurred during the last three years.