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Ann Thorac Surg 1990;50:309-311
© 1990 The Society of Thoracic Surgeons

Articles

Acute symptoms due to a huge duplication cyst ruptured into the esophagus

Kazuya Nakahara, MD*, Yoshitaka Fujii, MD, Shinichiro Miyoshi, MD, Akihiro Yoneda, MD, Masahiko Miyata, MD, Yasunaru Kawashima, MD

First Department of Surgery, Osaka University Medical School, Osaka, Japan

Accepted for publication March 27, 1990.

* Address reprint requests to Dr Nakahara, First Department of Surgery, Osaka University Medical School, 1-1-50, Fukushima, Fukushima-ku, Osaka, 553, Japan.

A 36-year-old housewife complained of a tight feeling in the pharynx with increasing dysphagia, dyspnea, and mild fever. Chest roentgenogram was interpreted as a cystic mast in the middle mediastinum. Computed tomography showed a cystic mass compressing the carina and the esophagus. Ten days after onset, symptoms were suddenly relieved followed by a tarry stool. The chest mass shadow decreased. Esophagofiberscopy showed two fistulas communicating with a cyst that had two chambers. Thoracotomy performed 40 days after onset showed a true duplication of the esophagus with rupture into the esophagus. This is a rare case in which it was possible to observe the sequence of events of a ruptured intramural duplication cyst by means of chest roentgenography, computed tomography, esophagofiberscopy, and cystogram.




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