Diagnostic challenge and surgical management of Boerhaave’s syndrome: a case series

Abstract Background Boerhaave’s syndrome is the spontaneous rupture of the esophagus, which requires early diagnosis and treatment. Symptoms may vary, and diagnosis can be challenging. Case presentation Case 1: A 54-year-old Chinese man presented to us with sudden-onset epigastric pain radiating to...

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Autores principales:	Jiayue Wang, Degang Wang, Jianjiao Chen
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Boerhaave’s syndrome Esophageal perforation CT Surgical management Medicine R
Acceso en línea:	https://doaj.org/article/3981104691964746bc201c137f621ec3
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spelling	oai:doaj.org-article:3981104691964746bc201c137f621ec32021-11-14T12:37:51ZDiagnostic challenge and surgical management of Boerhaave’s syndrome: a case series 10.1186/s13256-021-03080-11752-1947https://doaj.org/article/3981104691964746bc201c137f621ec32021-11-01T00:00:00Zhttps://doi.org/10.1186/s13256-021-03080-1https://doaj.org/toc/1752-1947Abstract Background Boerhaave’s syndrome is the spontaneous rupture of the esophagus, which requires early diagnosis and treatment. Symptoms may vary, and diagnosis can be challenging. Case presentation Case 1: A 54-year-old Chinese man presented to us with sudden-onset epigastric pain radiating to the back following hematemesis. Upper gastrointestinal endoscopy revealed a full-thickness rupture of the esophageal wall. Subsequent computed tomography showed frank pneumomediastinum and heterogeneous pleural effusion. Immediately, esophageal perforation repair operation and jejunostomy were performed. The postoperative period was uneventful, and he was discharged. Case 2: A 62-year-old Chinese man was admitted to the emergency department with thoracic dull pain and chest distress. Chest computed tomography scan showed pneumomediastinum and large left-sided pleural effusion. Esophagus fistula was confirmed by contrast esophagography. Then, we performed thoracotomy to repair the esophageal tear as well as to debride and irrigate the left pleural space. His postoperative period was uneventful, with no leakage or stricture. Case 3: The patient was a 69-year-old Chinese male presenting with severe retrosternal and upper abdominal pain following an episode of forceful vomiting. Thoracic computed tomography scan revealed a rupture in the left distal part of the esophagus, a pneumomediastinum, and left-sided pleural effusions. Conservative treatment failed to improve disease conditions. Open thoracic surgery was performed with debridement and drainage of the mediastinum and the pleural cavity, after which he made a slow but full recovery. Conclusions We highlight that early diagnosis and appropriate surgical treatment are essential for optimum outcome in patients with esophageal rupture. We emphasize the importance of critical care support, particularly in the early stages of management.Jiayue WangDegang WangJianjiao ChenBMCarticleBoerhaave’s syndromeEsophageal perforationCTSurgical managementMedicineRENJournal of Medical Case Reports, Vol 15, Iss 1, Pp 1-7 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Boerhaave’s syndrome Esophageal perforation CT Surgical management Medicine R
spellingShingle	Boerhaave’s syndrome Esophageal perforation CT Surgical management Medicine R Jiayue Wang Degang Wang Jianjiao Chen Diagnostic challenge and surgical management of Boerhaave’s syndrome: a case series
description	Abstract Background Boerhaave’s syndrome is the spontaneous rupture of the esophagus, which requires early diagnosis and treatment. Symptoms may vary, and diagnosis can be challenging. Case presentation Case 1: A 54-year-old Chinese man presented to us with sudden-onset epigastric pain radiating to the back following hematemesis. Upper gastrointestinal endoscopy revealed a full-thickness rupture of the esophageal wall. Subsequent computed tomography showed frank pneumomediastinum and heterogeneous pleural effusion. Immediately, esophageal perforation repair operation and jejunostomy were performed. The postoperative period was uneventful, and he was discharged. Case 2: A 62-year-old Chinese man was admitted to the emergency department with thoracic dull pain and chest distress. Chest computed tomography scan showed pneumomediastinum and large left-sided pleural effusion. Esophagus fistula was confirmed by contrast esophagography. Then, we performed thoracotomy to repair the esophageal tear as well as to debride and irrigate the left pleural space. His postoperative period was uneventful, with no leakage or stricture. Case 3: The patient was a 69-year-old Chinese male presenting with severe retrosternal and upper abdominal pain following an episode of forceful vomiting. Thoracic computed tomography scan revealed a rupture in the left distal part of the esophagus, a pneumomediastinum, and left-sided pleural effusions. Conservative treatment failed to improve disease conditions. Open thoracic surgery was performed with debridement and drainage of the mediastinum and the pleural cavity, after which he made a slow but full recovery. Conclusions We highlight that early diagnosis and appropriate surgical treatment are essential for optimum outcome in patients with esophageal rupture. We emphasize the importance of critical care support, particularly in the early stages of management.
format	article
author	Jiayue Wang Degang Wang Jianjiao Chen
author_facet	Jiayue Wang Degang Wang Jianjiao Chen
author_sort	Jiayue Wang
title	Diagnostic challenge and surgical management of Boerhaave’s syndrome: a case series
title_short	Diagnostic challenge and surgical management of Boerhaave’s syndrome: a case series
title_full	Diagnostic challenge and surgical management of Boerhaave’s syndrome: a case series
title_fullStr	Diagnostic challenge and surgical management of Boerhaave’s syndrome: a case series
title_full_unstemmed	Diagnostic challenge and surgical management of Boerhaave’s syndrome: a case series
title_sort	diagnostic challenge and surgical management of boerhaave’s syndrome: a case series
publisher	BMC
publishDate	2021
url	https://doaj.org/article/3981104691964746bc201c137f621ec3
work_keys_str_mv	AT jiayuewang diagnosticchallengeandsurgicalmanagementofboerhaavessyndromeacaseseries AT degangwang diagnosticchallengeandsurgicalmanagementofboerhaavessyndromeacaseseries AT jianjiaochen diagnosticchallengeandsurgicalmanagementofboerhaavessyndromeacaseseries
_version_	1718429100653150208

Diagnostic challenge and surgical management of Boerhaave’s syndrome: a case series

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