Spontaneous contained transmural oesophageal rupture clinically resembling intramural rupture. A case report.

Spontaneous rupture of the oesophagus may occur either transmurally or intramurally. The symptoms, signs, clinical course, treatment and prognosis differ in the two types. Transmural rupture is generally regarded as a serious condition, usually requiring operative treatment and having a high morbidity and mortality. Intramural rupture is a much more benign condition, is treated non-operatively and has a good prognosis. A few cases have been documented in which a transmural rupture was contained within the mediastinum; an additional case is described. Under these circumstances the transmural rupture has the clinical features of an intramural rupture. It is suggested that transmural ruptures should be subdivided into those which are not contained (the vast majority) and those which are.