Skip to main content
NCBI home page
Journal of the National Medical Association logoLink to Journal of the National Medical Association
. 2006 Nov;98(11):1857–1859.

Successful conservative management of Boerhaave's syndrome with late presentation.

Hasan Türüt 1, Erkmen Gulhan 1, Pinar Yaran Adams 1, Guven Cetin 1
PMCID: PMC2569784  PMID: 17128698

Abstract

In this report, we describe the diagnostic, clinical and therapeutic aspects of a 22-year-old man who was diagnosed with a case of Boerhaave's syndrome (BS) 86 hours after acute onset of chest pain and dyspnea following forceful vomiting due to excessive ingestion of alcohol. Early diagnosis and prompt treatment is critical in BS due to the high mortality rates related to delay in diagnosis. We think the main criterion of prognosis is not only the free interval between diagnosis and treatment but the clinical form. We suggest conservative management, including intrathoracic lavage and close monitoring in patients with late presentation with a distal esophageal tear.

Full text

PDF
1857

Images in this article

1858Figure 1
on p.1858
1858Figure 2
on p.1858

Selected References

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

  1. Foroulis Christophoros N., Desimonas Nikolaos. Delayed rupture of a primary esophageal repair for Boerhaave's syndrome. Eur J Cardiothorac Surg. 2004 Oct;26(4):870–871. doi: 10.1016/j.ejcts.2004.07.012. [DOI] [PubMed] [Google Scholar]
  2. Jones W. G., 2nd, Ginsberg R. J. Esophageal perforation: a continuing challenge. Ann Thorac Surg. 1992 Mar;53(3):534–543. doi: 10.1016/0003-4975(92)90294-e. [DOI] [PubMed] [Google Scholar]
  3. Jougon Jacques, Mc Bride Tarun, Delcambre Frédéric, Minniti Antonio, Velly Jean-François. Primary esophageal repair for Boerhaave's syndrome whatever the free interval between perforation and treatment. Eur J Cardiothorac Surg. 2004 Apr;25(4):475–479. doi: 10.1016/j.ejcts.2003.12.029. [DOI] [PubMed] [Google Scholar]
  4. Kollmar Otto, Lindemann Werner, Richter Sven, Steffen Ingo, Pistorius Georg, Schilling Martin K. Boerhaave's syndrome: primary repair vs. esophageal resection--case reports and meta-analysis of the literature. J Gastrointest Surg. 2003 Sep-Oct;7(6):726–734. doi: 10.1016/s1091-255x(03)00110-0. [DOI] [PubMed] [Google Scholar]
  5. Lawrence D. R., Ohri S. K., Moxon R. E., Townsend E. R., Fountain S. W. Primary esophageal repair for Boerhaave's syndrome. Ann Thorac Surg. 1999 Mar;67(3):818–820. doi: 10.1016/s0003-4975(99)00043-0. [DOI] [PubMed] [Google Scholar]
  6. Muir A. D., White J., McGuigan J. A., McManus K. G., Graham A. N. Treatment and outcomes of oesophageal perforation in a tertiary referral centre. Eur J Cardiothorac Surg. 2003 May;23(5):799–804. doi: 10.1016/s1010-7940(03)00050-2. [DOI] [PubMed] [Google Scholar]
  7. Petruzziello Lucio, Tringali Andrea, Riccioni Maria Elena, Mutignani Massimiliano, Margaritora Stefano, Cesario Alfredo, Costamagna Guido. Successful early treatment of Boerhaave's syndrome by endoscopic placement of a temporary self-expandable plastic stent without fluoroscopy. Gastrointest Endosc. 2003 Oct;58(4):608–612. doi: 10.1067/s0016-5107(03)01885-6. [DOI] [PubMed] [Google Scholar]
  8. Salo J. A., Isolauri J. O., Heikkilä L. J., Markkula H. T., Heikkinen L. O., Kivilaakso E. O., Mattila S. P. Management of delayed esophageal perforation with mediastinal sepsis. Esophagectomy or primary repair? J Thorac Cardiovasc Surg. 1993 Dec;106(6):1088–1091. [PubMed] [Google Scholar]
  9. Vogel Stephen B., Rout W. Robert, Martin Tomas D., Abbitt Patricia L. Esophageal perforation in adults: aggressive, conservative treatment lowers morbidity and mortality. Ann Surg. 2005 Jun;241(6):1016–1023. doi: 10.1097/01.sla.0000164183.91898.74. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from Journal of the National Medical Association are provided here courtesy of National Medical Association

RESOURCES