Endoscopic Treatment of Boerhaave Syndrome Using a Removable Self-expandable Plastic Stent

Endoscopic clipping of spontaneous esophageal rupture: Case reports of three patients

“…Thoracoscopy has recently been reported for the treatment of this condition [8]. There are also several reports of non-operative treatment, by stopping all oral intake and providing intravenous nutrition or using a covered stent in patients with small ruptures localized to the mediastinum [3], [5]. However, the use of covered stents is occasionally associated with migration of the stent or perforation of the lower esophagus.…”

“…Surgery is the conventional treatment for patients with esophageal rupture. However, it has been reported recently that esophageal rupture localized to the mediastinum can be successfully treated non-operatively [3], [4], [5]. We suggest endoscopic clipping as a less invasive treatment strategy for patients not only with esophageal rupture localized to the mediastinum, but also for select patients with Boerhaave’s syndrome and pleural rupture.…”

Another case of chest pain on the acute medical take!: Figure 1

“…Intercostal drains are necessary to drain the pleural cavity. Endoscopic management of oesophageal perforation involves radiologically guided placement of self-expanding stents over the rupture site 13 14. Surgery aims to repair the oesophageal defect via thoracotomy with drainage of pleural and mediastinal cavities and was traditionally believed to improve survival when performed within 24 h 3 4…”

“…The newest treatment option for oesophageal perforation is endoscopic stenting, although there is much debate regarding effectiveness, patient selection and availability of this intervention 7 13 14 22. Stents used in early and delayed presentations of Boerhaave's syndrome have been shown to reduce mortality compared to conservative treatment alone 13 23.…”

Acute Respiratory Failure in a Patient With Spontaneous Esophageal Rupture (Boerhaave Syndrome)

“…21,22 Although the results of stent placement in patients with Boerhaave syndrome have been encouraging, some authors still consider self-expanding esophageal stents controversial. Endoscopic stent placement seems to be appropriate for selected patients without wide mediastinal contamination and sepsis.…”