ANATOMICAL MODELING OF SPONTANEOUS ESOPHAGEAL RUPTURE

Аннотация

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Background. Spontaneous rupture of the esophagus (SRE) is a disease with an unfavorable prognosis of life that occurs in the unchanged wall of the esophagus with an increase in intraluminal pressure caused by vomiting. Aim. Create an anatomical model of the SREwith a view to studying its mechanism. Material and Methods. The simulation was performed on pigs weighing 18-20 kg. The first group-dead pigs were isolated by the removal of organs by the method of R. Virchow, then a clamp was placed on the gatekeeper, sealing the gastric outlet; second group - the pressure of the esophageal wall rupture was measured in dead animals without extracting the organocomplex; third group - living animals under the anesthesia of endotracheal analgesia. For comparison, the pressure in the lumen of the esophagus and stomach was measured, which occurs with a gag reflex during diagnostic esophagogastroscopy (20 patients). Results and Discussion. In the first group, when the water pressure reaches 0.5±0.1 bar. there was a rupture of the small curvature of the stomach. The rupture of the wall of an isolated esophagus was obtained at a water pressure of 1.2 to 1.4 bar. The burst pressure of the esophagus in groups 2 and 3 was 0.9±0.1 and 0.7±0.1 bar. There was always a rupture along the left lateral wall of the over-diaphragmatic segment of the esophagus. The maximum intraluminal pressure in the gag reflex with FGD was an average of 0.15 bar. without a significant difference between the stomach and esophagus. Conclusions. The rupture of the wall of the stomach occurs at a lower intraluminal pressure than the rupture of the wall of the esophagus.The place of rupture of the esophagus is always the same. Intraluminal pressure, which occurs during vomiting, cannot lead to rupture of the esophagus wall, since it is much less than the burst pressure.