Highlights Boerhaave’s syndrome is a rare life-threatening condition, usually requiring urgent surgical treatment. Thoracic drainage may confirm diagnosis rapidly. Debridement and drainage of pleural space and mediastinum are essential in sepsis control. Damage control approach with oesophageal T-tube drainage may help in sepsis control, allowing delayed definitive oesophageal repair. The outcome is determined by rapid diagnosis and timely and effective treatment.

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The progresses made in minimally invasive surgery, make it not only possible to perform isolated cholecystectomy, but also to provide a totally laparoscopic treatment of common bile duct lithiasis. In this approach, the use of choledochoscopy is indispensable for diagnostic and therapeutic success. This study describes the use of a disposable endoscope for choledochoscopy in the laparoscopic treatment of choledocholithiasis. We have analyzed the use of the Ambu® aScope 3™ disposable endoscope, normally used for bronchoscopy, in nine consecutive patients needing choledochoscopy in our Hospital. The patient average age was 78 years. Total clearance of the bile duct was obtained in seven patients. Bile duct vacuity was not obtained in two patients, but this is not attributed to equipment failure. There was one case of hemoperitoneum not related to equipment usage. This device is easy to use and looks promising for choledochoscopy in laparoscopic treatment of coledocholithiasis.

Highlights Iatrogenic injury of the superior mesenteric artery is rare. This injury imparts a high risk of mortality due to visceral ischemia and death. An anastomosis to the splenic artery may be an easier solution than an aorto-mesenteric bypass.