The esophagus (the hollow tube that leads from the throat to the stomach) is rather difficult to injure but it can be injured gradually by backflow of acid from the stomach (gastroesophageal reflux or GERD). The esophagus may also be injured suddenly by swallowing caustic or acidic chemicals, irritating drugs, or sharp objects, or by extreme pressure. Extreme pressure can occur during violent vomiting, and violent vomiting can cause tears in the esophagus. A very serious injury is rupture of the esophagus. This injury is rare and can be caused by surgical procedures or by vomiting or swallowing a large mass of food.
Sudden injuries of the esophagus usually cause pain, often felt as sharp pain under the breastbone. They may also cause bleeding, and blood may appear in vomit or stool. Fainting may occur due to this pain, especially if the esophagus ruptures. This rupture allows food contents to spill into the mediastinum (the area of the chest bordered by the sternum in front, the spinal column in back, the entrance to the chest cavity above, and the diaphragm below) and causes mediastinitis.
Doctors use various methods to diagnose injuries of the esophagus. Methods include upper endoscopy and different types of x-rays.
Treatment of injuries to the esophagus depends on the cause of the injury.