Chest
Selected ReportsSurviving Boerhaave's Syndrome Without Thoracotomy
Section snippets
Case Report
A 48-year-old man at a nearby hospital experienced forceful vomiting after drinking Golytely resulting in severe chest pain, hypotension, and respiratory distress. Resuscitation included intravenous fluids, dopamine, and intubation. Myocardial infarction was initially diagnosed but was not substantiated. A chest radiograph revealed a left lower lobe infiltrate with a pleural effusion, and aspiration pneumonia was considered. Broad-spectrum antibiotic therapy was begun.
The following day,
Discussion
The diagnosis of Boerhaave's syndrome is often missed or delayed. Spontaneous esophageal rupture may present a clinical picture that can be confused with pneumonia, pneumothorax, lung abscess, myocardial infarction, pancreatitis, dissecting aneurysm, pulmonary embolus, pericarditis, or perforated ulcer.1,4, 5, 6
Early diagnosis prompt thoracotomy is the optimal approach to Boerhaave's syndrome. The operative mortality is 30 to 50 percent, but it approaches 100 percent without surgical
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Selective nonoperative management of contained intrathoracic esophageal disruptions
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Cited by (11)
Clinical microbiological case: Vomiting followed by breathlessness
2003, Clinical Microbiology and InfectionCitation Excerpt :If the patient presents within 24 h of rupture, then early surgical intervention, drainage and primary closure of the rupture site is generally indicated. In cases of delayed diagnosis (more than 24 h) with associated mediastinitis, suture of the rupture site may be performed, but the mortality appears equal to that with conservative treatment [8]. Conservative therapy consists of drainage of pleural collections, antimicrobial therapy, including cover for oral anaerobes while maintaining nutrition by enteral or parenteral feeding, and allowing the patient nothing by mouth until the tear has healed.
Boerhaave's syndrome: Case report
2013, Revista do Colegio Brasileiro de CirurgioesThoracoscopic repair for a spontaneous esophageal rupture (boerhaave's syndrome)
2010, IRYO - Japanese Journal of National Medical Services