The most immediate symptoms of a hole in the esophagus are chest and throat pains and difficulty swallowing and breathing. The struggle to breathe might also lead to low blood pressure due to lack of oxygen. As a result of the difficulty, the heart might overwork itself to compensate for the inefficiency, leading to increased heart rates. Discomforting signs, like air bubbles underneath the skin, might arise from the flow of air through the hole. If left unchecked, the hole might lead to more serious medical conditions, such as mediastinitis.
A hole in the esophagus, also referred to as esophageal perforation, occurs through a variety of causes. The most common cause is direct injury during a surgical procedure. For instance, an instrument might slip during an operation on the throat, tearing a hole in the esophagus.
Another common cause of esophageal perforation is gatrsoesophageal reflux disease (GERD). Individuals with GERD experience chronic reflux of stomach acid into the esophagus. This damages the mucosal lining of the throat, eventually burning through the esophageal wall itself. Paired with such a hole, GERD can lead to severe medical issues.
Less common causes of a hole in the esophagus include violent vomiting or the introduction of a foreign object into the esophagus. Esophageal tumors might also lead to esophageal perforation. In rare cases, external trauma might be powerful enough to cause internal damage in the throat, puncturing the esophagus.
Patients with a hole in the esophagus will often experience neck pain, generally around the site of perforation. The affected area might feel stiff or might contain a lump formed from an air bubble. As the esophagus is a major passageway for both food and air, individuals with a hole might experience difficulty in swallowing and in eating. If the perforation leaks food or air into the chest area, the patient might also experience significant chest pain.
Introduction of foreign matter into the chest can lead to mediastinitis, an infection of the surrounding area of the chest. If this occurs, the patient might develop additional symptoms, such as fever and the coughing up of blood. The infection will also cause the area to swell, making it even more difficult for the patient to breathe. Complications arising from the infection might eventually lead to death. Since a hole in the esophagus is a major cause of mediastinitis, it is imperative that the condition is treated immediately.