Table of ContentsView AllTable of ContentsTypesSymptomsComplicationsCausesTreatmentsFrequently Asked Questions

Table of ContentsView All

View All

Table of Contents

Types

Symptoms

Complications

Causes

Treatments

Frequently Asked Questions

Anesophageal tearis a tear in theesophagus—a tube that connects the mouth and throat to the stomach. Also known as an esophageal rupture or perforation, it’s a potentially life-threatening condition.

This article discusses different types of esophagus tears, symptoms, causes, and complications. It also details treatments for this potentially deadly internal injury.

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Telling a Doctor About Her Sore Throat

Types of Esophageal Tears

An esophageal tear is a rupture, laceration, or perforation in the wall of the esophagus. The esophagus, also known as the feeding tube, is made of a combination ofsmooth (involuntary) musclesand striated (voluntary) muscles as well as layers of connective tissues, structural tissues, andmucus-secreting tissues.

Symptoms of an Esophagus Tear

Signs and symptoms of an esophageal tear include:

An esophageal tear can mimic conditions such as aheart attack,acute pancreatitis(inflammation of the pancreas), and severepeptic ulcers(stomach ulcers). Unfortunately, because of this, treatment is sometimes delayed until the condition has rapidly worsened.

When to Seek Medical AttentionAn esophageal tear is always considered a medical emergency in need of immediate treatment. If left untreated, even minor tears can worsen and rapidly increase in size and severity. If you are experiencing symptoms of a tear, go to the emergency room.

When to Seek Medical Attention

An esophageal tear is always considered a medical emergency in need of immediate treatment. If left untreated, even minor tears can worsen and rapidly increase in size and severity. If you are experiencing symptoms of a tear, go to the emergency room.

Possible Complications

An esophageal tear poses serious health concerns as it allows food or fluids to leak into the chest and cause potentially severe lung problems and infections, among other things.

With Boerhaave’s syndrome, the spontaneous rupture of the esophagus is associated with a high risk of death even with treatment.

Possible complications of an esophageal tear include:

If untreated, esophageal tears can rapidly worsen and even lead to death.Death from esophageal tears is often the result of sepsis and a rapid drop in blood pressure, leading toshockand major organ failure.

Esophageal tears are fairly uncommon but can be extremely severe. The causes of these tears can be broadly categorized as either being intraluminal or extraluminal.

Intraluminal Causes

Intraluminal causes of an esophageal tear include:

Extraluminal Causes

Some extraluminal causes of an esophageal tear include:

According to a 2017 review published inDiseases of the Esophagus,46.5% of all esophageal tears are the result of diagnostic and therapeutic procedures, such as anesophageal endoscopy.

An esophagus tear in the neck area may heal on its own. However, you will not be able to eat or drink until it is healed, which means you will need a feeding tube.

Depending on the location and size of the esophagus tear, surgery may be required. Tears in the middle and bottom parts of the esophagus will require more extensive treatments. If the tear is small and the leaking is minimal, your surgeon may plug the hole with a stent. More severe tears may be treated with a simple repair. In extreme cases, the esophagus may need to be removed.

In most cases, a Mallory-Weiss tear will stop bleeding and begin to heal on its own. If treatment is needed, your surgeon may perform an endoscopy to give an injection, cauterize the bleeding area, or insert a clip to close the tear and stop the bleeding.

Other treatments for an esophagus tear include:

Summary

An esophageal tear is a rupture, laceration, or perforation on the wall of the esophagus. While most cases are due to medical procedures that physically injure the esophagus, others are due to things like severe vomiting, foreign bodies, caustic substances, or cancer.

Esophageal tears can cause a cascade of symptoms easily mistaken for a heart attack or a severe peptic ulcer. These include extreme chest pain, rapid heartbeat, shallow breathing, radiating shoulder pain, shortness of breath, and vomiting.

If left untreated, esophageal tears can lead to sepsis, shock, and even death. Esophageal tears often require surgery and in extreme cases may require removal of the esophagus.

A Word From Verywell

Not all esophageal tears require surgical repair, but that doesn’t mean they are any less serious. Because swallowing and eating cause the contraction of esophageal walls, even tiny tears can progressively become severe.

Surgery is almost always needed, particularly for tears in the middle or lower part of the esophagus.

Frequently Asked QuestionsA tear in the uppermost part of the esophagus near the neck may heal if you do not eat or drink for a period. In such cases, you will need a feeding tube that directly delivers nutrition into your stomach until the tear adequately heals.Learn MoreAll About Feeding TubesSurgery is almost always needed to repair a tear, especially one in the middle or bottom portions of the esophagus.It depends on the severity of the tear and the type of surgery used. The injury can often heal within 72 hours of treatment with partial tears, such as with Mallory-Weiss syndrome.Other tears can take weeks or even months to heal.With certain types of esophageal tears, such as Boerhaave syndrome, the risk of death is nearly 100% if left untreated. Even when treated, the risk of death is around 25% if treatment is delivered within 24 hours.

A tear in the uppermost part of the esophagus near the neck may heal if you do not eat or drink for a period. In such cases, you will need a feeding tube that directly delivers nutrition into your stomach until the tear adequately heals.Learn MoreAll About Feeding Tubes

A tear in the uppermost part of the esophagus near the neck may heal if you do not eat or drink for a period. In such cases, you will need a feeding tube that directly delivers nutrition into your stomach until the tear adequately heals.

Learn MoreAll About Feeding Tubes

Surgery is almost always needed to repair a tear, especially one in the middle or bottom portions of the esophagus.

It depends on the severity of the tear and the type of surgery used. The injury can often heal within 72 hours of treatment with partial tears, such as with Mallory-Weiss syndrome.Other tears can take weeks or even months to heal.

With certain types of esophageal tears, such as Boerhaave syndrome, the risk of death is nearly 100% if left untreated. Even when treated, the risk of death is around 25% if treatment is delivered within 24 hours.

12 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Raju GS.Esophageal perforations.Gastroenterol Hepatol (N Y). 2012;8(8):548–551. PMID:23293570MedlinePlus.Esophagus disorders.Tullavardhana T.Iatrogenic esophageal perforation,J Med Assoc Thai. 2015 Oct;98 Suppl 9:S177-83.Tamatey NM, Sereboe LA, Tettey NM, Entsua-Mensah K, Gyan B.Boerhaave’s syndrome: diagnosis and successful primary repair one month after the oesophageal perforation.Ghana Med J.2013 Mar;47(1):53–55.Li H, Li ZB, Zhu HD, Wu XL, Tian DA, Li PY.The prediction value of scoring systems in Mallory-Weiss syndrome patients.Medicine (Baltimore).2019 May;98(22):e15751. doi:10.1097/MD.0000000000015751Eroglu A, Aydin Y, Yilmaz O.Minimally invasive management of esophageal perforation.Turk Gogus Kalp Damar Cerrahisi Derg.2018 Jul;26(3):496–503. doi:10.5606/tgkdc.dergisi.2018.15354Hayakawa S, Ogawa R, Ito S, et al.Suitable diagnosis and treatment of esophageal ruptures in cases of non-Boerhaave syndrome: a comparison with Boerhaave syndrome.J Investig Med High Impact Case Rep. 2021 Jan-Dec;9:23247096211014683. doi:10.1177/23247096211014683MedlinePlus. Esophageal perforation.Sdralis EIK, Petousis S, Rashid F, et al.Epidemiology, diagnosis, and management of esophageal perforations: systematic review.Dis Esophagus.2017;30:1-6. doi:10.1093/dote/dox013MedlinePlus.Esophageal perforation.Johns Hopkins Medicine.Mallory-Weiss tear.Tejani N, Bowditch S, Engstad K, Ranasinghe L.An unusual case of esophageal rupture.J Clin Case Rep Case Stud. 2018:19-22:CCCS-101015. doi:https://10.29199/2637-9309/CCCS-101015Additional ReadingSøreide JA, Viste A.Esophageal perforation: diagnostic work-up and clinical decision-making in the first 24 hours.Scand J Trauma Resusc Emerg Med. 2011;19:66. doi:10.1186/1757-7241-19-66

12 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Raju GS.Esophageal perforations.Gastroenterol Hepatol (N Y). 2012;8(8):548–551. PMID:23293570MedlinePlus.Esophagus disorders.Tullavardhana T.Iatrogenic esophageal perforation,J Med Assoc Thai. 2015 Oct;98 Suppl 9:S177-83.Tamatey NM, Sereboe LA, Tettey NM, Entsua-Mensah K, Gyan B.Boerhaave’s syndrome: diagnosis and successful primary repair one month after the oesophageal perforation.Ghana Med J.2013 Mar;47(1):53–55.Li H, Li ZB, Zhu HD, Wu XL, Tian DA, Li PY.The prediction value of scoring systems in Mallory-Weiss syndrome patients.Medicine (Baltimore).2019 May;98(22):e15751. doi:10.1097/MD.0000000000015751Eroglu A, Aydin Y, Yilmaz O.Minimally invasive management of esophageal perforation.Turk Gogus Kalp Damar Cerrahisi Derg.2018 Jul;26(3):496–503. doi:10.5606/tgkdc.dergisi.2018.15354Hayakawa S, Ogawa R, Ito S, et al.Suitable diagnosis and treatment of esophageal ruptures in cases of non-Boerhaave syndrome: a comparison with Boerhaave syndrome.J Investig Med High Impact Case Rep. 2021 Jan-Dec;9:23247096211014683. doi:10.1177/23247096211014683MedlinePlus. Esophageal perforation.Sdralis EIK, Petousis S, Rashid F, et al.Epidemiology, diagnosis, and management of esophageal perforations: systematic review.Dis Esophagus.2017;30:1-6. doi:10.1093/dote/dox013MedlinePlus.Esophageal perforation.Johns Hopkins Medicine.Mallory-Weiss tear.Tejani N, Bowditch S, Engstad K, Ranasinghe L.An unusual case of esophageal rupture.J Clin Case Rep Case Stud. 2018:19-22:CCCS-101015. doi:https://10.29199/2637-9309/CCCS-101015Additional ReadingSøreide JA, Viste A.Esophageal perforation: diagnostic work-up and clinical decision-making in the first 24 hours.Scand J Trauma Resusc Emerg Med. 2011;19:66. doi:10.1186/1757-7241-19-66

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Raju GS.Esophageal perforations.Gastroenterol Hepatol (N Y). 2012;8(8):548–551. PMID:23293570MedlinePlus.Esophagus disorders.Tullavardhana T.Iatrogenic esophageal perforation,J Med Assoc Thai. 2015 Oct;98 Suppl 9:S177-83.Tamatey NM, Sereboe LA, Tettey NM, Entsua-Mensah K, Gyan B.Boerhaave’s syndrome: diagnosis and successful primary repair one month after the oesophageal perforation.Ghana Med J.2013 Mar;47(1):53–55.Li H, Li ZB, Zhu HD, Wu XL, Tian DA, Li PY.The prediction value of scoring systems in Mallory-Weiss syndrome patients.Medicine (Baltimore).2019 May;98(22):e15751. doi:10.1097/MD.0000000000015751Eroglu A, Aydin Y, Yilmaz O.Minimally invasive management of esophageal perforation.Turk Gogus Kalp Damar Cerrahisi Derg.2018 Jul;26(3):496–503. doi:10.5606/tgkdc.dergisi.2018.15354Hayakawa S, Ogawa R, Ito S, et al.Suitable diagnosis and treatment of esophageal ruptures in cases of non-Boerhaave syndrome: a comparison with Boerhaave syndrome.J Investig Med High Impact Case Rep. 2021 Jan-Dec;9:23247096211014683. doi:10.1177/23247096211014683MedlinePlus. Esophageal perforation.Sdralis EIK, Petousis S, Rashid F, et al.Epidemiology, diagnosis, and management of esophageal perforations: systematic review.Dis Esophagus.2017;30:1-6. doi:10.1093/dote/dox013MedlinePlus.Esophageal perforation.Johns Hopkins Medicine.Mallory-Weiss tear.Tejani N, Bowditch S, Engstad K, Ranasinghe L.An unusual case of esophageal rupture.J Clin Case Rep Case Stud. 2018:19-22:CCCS-101015. doi:https://10.29199/2637-9309/CCCS-101015

Raju GS.Esophageal perforations.Gastroenterol Hepatol (N Y). 2012;8(8):548–551. PMID:23293570

MedlinePlus.Esophagus disorders.

Tullavardhana T.Iatrogenic esophageal perforation,J Med Assoc Thai. 2015 Oct;98 Suppl 9:S177-83.

Tamatey NM, Sereboe LA, Tettey NM, Entsua-Mensah K, Gyan B.Boerhaave’s syndrome: diagnosis and successful primary repair one month after the oesophageal perforation.Ghana Med J.2013 Mar;47(1):53–55.

Li H, Li ZB, Zhu HD, Wu XL, Tian DA, Li PY.The prediction value of scoring systems in Mallory-Weiss syndrome patients.Medicine (Baltimore).2019 May;98(22):e15751. doi:10.1097/MD.0000000000015751

Eroglu A, Aydin Y, Yilmaz O.Minimally invasive management of esophageal perforation.Turk Gogus Kalp Damar Cerrahisi Derg.2018 Jul;26(3):496–503. doi:10.5606/tgkdc.dergisi.2018.15354

Hayakawa S, Ogawa R, Ito S, et al.Suitable diagnosis and treatment of esophageal ruptures in cases of non-Boerhaave syndrome: a comparison with Boerhaave syndrome.J Investig Med High Impact Case Rep. 2021 Jan-Dec;9:23247096211014683. doi:10.1177/23247096211014683

MedlinePlus. Esophageal perforation.

Sdralis EIK, Petousis S, Rashid F, et al.Epidemiology, diagnosis, and management of esophageal perforations: systematic review.Dis Esophagus.2017;30:1-6. doi:10.1093/dote/dox013

MedlinePlus.Esophageal perforation.

Johns Hopkins Medicine.Mallory-Weiss tear.

Tejani N, Bowditch S, Engstad K, Ranasinghe L.An unusual case of esophageal rupture.J Clin Case Rep Case Stud. 2018:19-22:CCCS-101015. doi:https://10.29199/2637-9309/CCCS-101015

Søreide JA, Viste A.Esophageal perforation: diagnostic work-up and clinical decision-making in the first 24 hours.Scand J Trauma Resusc Emerg Med. 2011;19:66. doi:10.1186/1757-7241-19-66

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