A Successful Strategy for Surgical Treatment of Boerhaave’s Syndrome Sans Thoracotomy

Adhikari, Devbrata; Tiwari, Ashutosh; Vankipuram, Siddharth; Chaphekar, Aniruddha Prabhakar; Satardey, Ritesh

doi:10.7860/jcdr/2015/13517.6263

Cited by 2 publications

(2 citation statements)

References 9 publications

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“…For patients in late period (>72 h), the ideal treatment strategy (conservation or surgery) is still under dispute. Conservative treatment mainly includes antibiotics and thoracentesis–tube drainage, and some studies [ 18 , 19 ] have reported that several cases have been cured without surgery. However, there are no supporting tissues such as omentum majus in the chest, so inflammation can easily infiltrate throughout the mediastinum and cause severe sepsis in weak patients.…”

Section: Discussionmentioning

confidence: 99%

The Role of Operation in the Treatment of Boerhaave’s Syndrome

Han

Huang

Xiang

et al. 2018

BioMed Research International

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Purpose This study aims to discuss the appropriate treatment strategy for spontaneous esophageal rupture. Methods Clinical data from twenty-one cases were retrospectively analyzed. The parameters included etiology, time interval between onset and treatment, therapy methods, prognosis, and length of stay. Results The ratio of males/females was 17/4, age range was 32–82 years (mean = 43.1), and the time interval between onset and treatment was as follows: <24 h: nine cases (42.8%); 24–48 h: six cases (28.6%); and >72 h: six cases (28.6%). All patients underwent operative treatment, and the following primary healing rates were achieved: <24 h: 88.9%, 24–48 h: 66.7%, and >72 h: 0. No patients died in this study. All patients were discharged with recovery, and the average hospitalization times were 18.1 days (<24 h), 27.8 days (24–48 h), and 51.2 days (>72 h). Conclusions Surgical treatment remains an effective method for treating spontaneous esophageal rupture, and the shorter the time interval between onset and treatment, possibly the better the prognosis.

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Section: Discussionmentioning

confidence: 99%

The Role of Operation in the Treatment of Boerhaave’s Syndrome

Han

Huang

Xiang

et al. 2018

BioMed Research International

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“…A method of constructing a gastrostomy, creating a proximal diverting cervical esophagostomy, inserting a chest drainage tube, administering conservative treatment, and closing the cervical esophagostomy has been reported [21] . Given the size of the esophageal perforation and the deterioration in the color of the mucous membrane in the present patient, it may be difficult to save the patient using this reported method.…”

Section: Discussionmentioning

confidence: 99%

Subtotal esophagectomy followed by subtotal gastric reconstruction for Boerhaave's syndrome: Case report with literature review

Tanaka

Ohno

Sato

et al. 2022

International Journal of Surgery Case Reports

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Introduction Boerhaave's syndrome, or spontaneous esophageal rupture, is a potentially fatal disease requiring prompt diagnosis and effective treatment. We report Boerhaave's syndrome in a patient who underwent subtotal esophagectomy and temporary cervical esophagostomy for esophageal perforation to the right thoracic cavity, followed by subtotal gastric reconstruction as the second step. Presentation of case A 70-year-old man with diarrhea and vomiting as chief complaints had underlying disease of reflux esophagitis. He experienced frequent hematemesis. Computed tomography (CT) at another hospital revealed right pleural effusion and abnormal mediastinal air and fluid retention around the esophagus, and he was transferred to our hospital. From the CT findings, he was diagnosed as having Boerhaave's syndrome with esophageal perforation into the right thoracic cavity. He was in shock, and emergency right thoracotomy was performed, revealing a severely purulent thoracic cavity, ruptured parietal pleura, and 5-cm perforation in the right front middle esophageal wall that was surrounded by mucosal necrosis. Subtotal esophagectomy, temporal cervical esophagostomy, and enteral feeding tube insertion were performed. After hospital discharge, he underwent subtotal gastric reconstruction 43 days postoperatively. His course was good, and he was transferred to another hospital for rehabilitation 36 days after reconstruction. Discussion In Boerhaave's syndrome, depending on the size of the perforation and fragility of the esophageal wall, subtotal esophagectomy may be feasible. Conclusion Two-step reconstruction following esophageal rupture is possible after sufficient local infection control, and anastomosis can be performed if the patient's general condition is good, but only under conditions that guarantee no anastomotic leakage.

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A Successful Strategy for Surgical Treatment of Boerhaave’s Syndrome Sans Thoracotomy

Cited by 2 publications

References 9 publications

The Role of Operation in the Treatment of Boerhaave’s Syndrome

The Role of Operation in the Treatment of Boerhaave’s Syndrome

Subtotal esophagectomy followed by subtotal gastric reconstruction for Boerhaave's syndrome: Case report with literature review

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