Skip to main content
PMC home page
Annals of Surgery logoLink to Annals of Surgery
. 1976 Apr;183(4):401–408. doi: 10.1097/00000658-197604000-00013

Boerhaave's syndrome: The importance of early diagnosis and treatment.

J J Curci, M J Horman
PMCID: PMC1344212  PMID: 1267496

Abstract

Boerhaave's syndrome, spontaneous esophageal rupture, is associated with a 70% survival with surgical intervention. Mortality and morbidity are increased in direct proportion to the time between diagnosis and appropriate surgical intervention. Sepsis, hypovolemia and shock are the predominant causes of morbidity and mortality in Boerhaave's syndrome. Two cases of Boerhaave's syndrome are presented which were diagnosed rapidly, and were managed surgically, resulting in survival of the patients. A review of the literature is also presented with emphasis on the clinical and roentgenologic methods of diagnosis of spontaneous esophageal rupture. Particular attention is given to the fact that early diagnosis and treatment will unquestionably reduce the morbidity of this syndrome.

Full text

PDF
401

Images in this article

402Fig. 1.
on p.402
403Fig. 2.
on p.403
403Fig. 3.
on p.403

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Abbott O. A., Mansour K. A., Logan W. D., Jr, Hatcher C. R., Jr, Symbas P. N. Atraumatic so-called "spontaneous" rupture of the esophagus. A review of 47 personal cases with comments on a new method of surgical therapy. J Thorac Cardiovasc Surg. 1970 Jan;59(1):67–83. [PubMed] [Google Scholar]
  2. Bennett D. J., Deveridge R. J., Wright J. S. Spontaneous rupture of the esophagus: a review with reports of six cases. Surgery. 1970 Nov;68(5):766–770. [PubMed] [Google Scholar]
  3. Berne C. J., Shader A. E., Doty D. B. Treatment of effort rupture of the esophagus by epigastric celiotomy. Surg Gynecol Obstet. 1969 Aug;129(2):277–280. [PubMed] [Google Scholar]
  4. Bobo W. O., Billups W. A., Hardy J. D. Boerhaave's syndrome: a review of six cases of spontaneous rupture of the esophagus secondary to vomiting. Ann Surg. 1970 Dec;172(6):1034–1038. doi: 10.1097/00000658-197012000-00017. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Bryant L. R., Eiseman B. Experimental evaluation of intercostal pedicle grafts in esophageal repair. J Thorac Cardiovasc Surg. 1965 Nov;50(5):626–631. [PubMed] [Google Scholar]
  6. Callaghan J. The Boerhaave syndrome (spontaneous rupture of the oesophagus). Br J Surg. 1972 Jan;59(1):41–44. doi: 10.1002/bjs.1800590111. [DOI] [PubMed] [Google Scholar]
  7. DERBES V. J., MITCHELL R. E., Jr Rupture of the esophagus. Surgery. 1956 Apr;39(4):688–709. [PubMed] [Google Scholar]
  8. DERBES V. J., MITCHELL R. E., Jr Rupture of the esophagus. Surgery. 1956 May;39(5):865–888. [PubMed] [Google Scholar]
  9. DORSEY J. M., HOHF R. P., LYNN T. E. Relationship of peptic esophagitis to spontaneous rupture of esophagus. AMA Arch Surg. 1959 Jun;78(6):878–888. doi: 10.1001/archsurg.1959.04320060066009. [DOI] [PubMed] [Google Scholar]
  10. Fernandez D. Another esophageal rupture after alcohol and disulfiram. N Engl J Med. 1972 Mar 16;286(11):610–610. doi: 10.1056/NEJM197203162861123. [DOI] [PubMed] [Google Scholar]
  11. HOPPER C. L., BERK P. D., HOWES E. L. Strength of esophageal anastomoses repaired with autogenous pericardial grafts. Surg Gynecol Obstet. 1963 Jul;117:83–86. [PubMed] [Google Scholar]
  12. Hardy J. D., Tompkins W. C., Jr, Ching E. C., Chavez C. M. Esophageal perforations and fistulas: review of 36 cases with operative closure of four chronic fistulas. Ann Surg. 1973 Jun;177(6):788–797. doi: 10.1097/00000658-197306000-00019. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Keighley M. R., Girdwood R. W., Ionescu M. I., Wooler G. H. Spontaneous rupture of the oesophagus. Avoidance of postoperative morbidity. Br J Surg. 1972 Aug;59(8):649–652. doi: 10.1002/bjs.1800590818. [DOI] [PubMed] [Google Scholar]
  14. Kossick P. R. Spontaneous rupture of the oesophagus. S Afr Med J. 1973 Oct 6;47(39):1807–1809. [PubMed] [Google Scholar]
  15. LILLINGTON G. A., BERNATZ P. E. Spontaneous perforation of the esophagus. Dis Chest. 1961 Feb;39:177–184. doi: 10.1378/chest.39.2.177. [DOI] [PubMed] [Google Scholar]
  16. Larrieu A. J., Kieffer R. Boerhaave syndrome: report of a case treated non-operatively. Ann Surg. 1975 Apr;181(4):452–454. doi: 10.1097/00000658-197504000-00015. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Lowman R. M., Goldman R., Stern H. The roentgen aspects of intramural dissection of the esophagus. The mucosal stripe sign. Radiology. 1969 Dec;93(6):1329–1331. doi: 10.1148/93.6.1329. [DOI] [PubMed] [Google Scholar]
  18. Mansour K. A., Teaford H. Atraumatic rupture of the esophagus into the pericardium simulating acute myocardial infarction. A case report. J Thorac Cardiovasc Surg. 1973 Mar;65(3):458–461. [PubMed] [Google Scholar]
  19. NACLERIO E. A. The V sign in the diagnosis of spontaneous rupture of the esophagus (an early roentgen clue). Am J Surg. 1957 Feb;93(2):291–298. doi: 10.1016/0002-9610(57)90781-x. [DOI] [PubMed] [Google Scholar]
  20. Nissen R. Bridging of Esophageal Defect by Pedicled Flap of Lung Tissue. Ann Surg. 1949 Jan;129(1):142–147. doi: 10.1097/00000658-194901000-00017. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Rao K. V., Mir M., Cogbill C. L. Management of perforations of the thoracic esophagus: a new technic utilizing a pedicle flap of diaphragm. Am J Surg. 1974 May;127(5):609–612. doi: 10.1016/0002-9610(74)90329-8. [DOI] [PubMed] [Google Scholar]
  22. Rosoff L., Sr, White E. J. Perforation of the esophagus. Am J Surg. 1974 Aug;128(2):207–218. [PubMed] [Google Scholar]
  23. SANDERSON R. G. SPONTANEOUS RUPTURE OF THE ESOPHAGUS; REPORT OF SURVIVAL WITHOUT SURGICAL MANAGEMENT. Am J Surg. 1965 Apr;109:506–508. doi: 10.1016/s0002-9610(65)80186-6. [DOI] [PubMed] [Google Scholar]
  24. SEALY W. C. Rupture of the esophagus. Am J Surg. 1963 Apr;105:505–510. doi: 10.1016/0002-9610(63)90322-2. [DOI] [PubMed] [Google Scholar]
  25. STRAUCH G. O., LYNCH R. E. SUBPHRENIC EXTRATHORACIC RUPTURE OF THE ESOPHAGUS: FIRST REPORTED CASE. Ann Surg. 1965 Feb;161:213–217. doi: 10.1097/00000658-196502000-00008. [DOI] [PMC free article] [PubMed] [Google Scholar]
  26. THAL A. P., HATAFUKU T. IMPROVED OPERATION FOR ESOPHAGEAL RUPTURE. JAMA. 1964 Jun 1;188:826–828. doi: 10.1001/jama.1964.03060350052018. [DOI] [PubMed] [Google Scholar]
  27. Thompson N. W., Ernst C. B., Fry W. J. The spectrum of emetogenic injury to the esophagus and stomach. Am J Surg. 1967 Jan;113(1):13–26. doi: 10.1016/0002-9610(67)90251-6. [DOI] [PubMed] [Google Scholar]

Articles from Annals of Surgery are provided here courtesy of Lippincott, Williams, and Wilkins

RESOURCES