Eosinophilic esophagitis presenting with spontaneous esophageal rupture: a case report

Tanureet Kochar,Brittain Mcjunkin,Muhammad Farhan Khaliq,Parminder Singh Dhingra

doi:10.1186/s13256-019-2207-4

Abstract

BackgroundEosinophilic esophagitis, once considered a rare disorder, has been increasingly recognized as a leading cause of dysphagia and food impaction in children and adults over the last few decades. It predominantly occurs in young men with a history of atopy. Dysphagia and food impaction are the most common presentations. However, rarely, spontaneous perforation (Boerhaave’s syndrome) may occur in association with eosinophilic esophagitis.Case presentationA 40-year-old white woman with known history of eosinophilic esophagitis, who was non-compliant with treatment, presented with chest pain and developed acute spontaneous transmural esophageal perforation while eating a snack. Surgical repair was required.ConclusionIn a relatively young patient who presents with spontaneous esophageal perforation, eosinophilic esophagitis should always be ruled out as subsequent treatment may prevent recurrent perforation.

Highlights

Eosinophilic esophagitis (EoE) was first described in the mid-1990s [1, 2]
EoE is a clinicopathological diagnosis requiring the presence of esophageal symptoms and eosinophils on histology
Allergic and atopic conditions are seen in approximately 43% of the patients with EoE [6]

Summary

Conclusion

In a young patient with spontaneous esophageal rupture and no predisposing factors, such as binge alcoholism, EoE should be considered the most likely cause. Confirmation of diagnosis appears to be extremely important, as followup pharmacologic and/or dietary treatment may minimize future complications, including recurrent perforation

Introduction

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Discussion