scholarly journals 977 Successful Endoscopic Closure of Spontaneous Esophageal Rupture (Boerhaave Syndrome)

2014 ◽  
Vol 79 (5) ◽  
pp. AB185
Author(s):  
Stijn J. Van Weyenberg ◽  
Fred J. Stam ◽  
Willem Marsman
2019 ◽  
Vol 32 (Supplement_2) ◽  
Author(s):  
B  Movchan ◽  
O Usenko ◽  
A Zgonnyk ◽  
R Vynogradov

Abstract Aim To study the most effective method of treatment in patients with spontaneous rupture of the esophagus. Background The timely diagnosis of Boerhaave syndrome presents great difficulties due to its rarity, a variety of clinical manifestations, often simulating different pathologies from other organs and are difficult to treat. Methods From 2003 to 2019 9 patients with Bourhave's syndrome were treated at the clinic, primary care was provided to 6 patients in the community. All patients were admitted to the clinic with external left-sided esophageal-pleural fistula, 1 patient had a spontaneous rupture of the esophagus in the cliniс, the defect of the esophagus wall defect was completed, which led to successful results. Results Treatment in the remaining patients was started with adequate enteral nutrition and effective drainage of the pleural cavity. As a result of the use of pleural double-lumen drainage with active sanation with antiseptics and subsequent aspiration, with the exception of feeding through the mouth in four patients, it was possible to eliminate the esophageal-pleural fistula, profuse bleeding and death of the patient. Against the background of ongoing conservative therapy in two patients, it was not possible to eliminate the esophago-pleural fistula. A left-sided thoracotomy was performed with excision of the fistula with the decortication of the lung and the extirpation of the esophagus with the formation of an esophagostomy. Subsequently, these patients underwent retrosternal colic esophagoplasty. Two patients underwent Lewis surgery with drainage of the pleural cavity. Conclusion Boerhaave syndrome has a very high mortality rate, however, with a timely diagnosis and adequate surgical tactics, it develops into the formation of an esophageal-pleural fistula. In this case, the most effective treatment is excision of the fistulous course with extirpation of the esophagus and subsequent esophagoplasty. The use of esophageal stents is possible in extremely depleted patients or in elderly patients, due to the frequent occurrence of hypergranular esophagitis. Esophageal stents should be removed as soon as possible when confidence in the elimination of the esophageal-pleural fistula occurs.


2021 ◽  
Vol 80 ◽  
pp. 105691
Author(s):  
Hirokatsu Hayashi ◽  
Narutoshi Nagao ◽  
Kenji Yamazaki ◽  
Ryuichi Asai ◽  
Chihiro Tanaka ◽  
...  

2014 ◽  
Vol 99 (6) ◽  
pp. 842-845 ◽  
Author(s):  
Hiroshi Naitoh ◽  
Minoru Fukuchi ◽  
Shinsuke Kiriyama ◽  
Takaharu Fukasawa ◽  
Yuichi Tabe ◽  
...  

Abstract A 52-year-old man was admitted to our hospital with a spontaneous esophageal rupture (Boerhaave syndrome) and was successfully treated. Eight years after the first incident, he was readmitted with a recurrent rupture. Recurrence of Boerhaave syndrome is extremely rare, with only 7 cases reported in the English literature. During treatment, the patient was also diagnosed with antiphospholipid syndrome (APS). Although APS is known to cause a variety of symptoms due to vascular thrombosis, recurrence of Boerhaave syndrome, coincident with APS, has never been reported. The pathogenesis of Boerhaave syndrome has not been clearly determined. This report serves to increase awareness of the risk of APS, which results in an increased risk of spontaneous rupture of the esophagus.


2011 ◽  
Vol 56 (3) ◽  
pp. 347-350 ◽  
Author(s):  
P. Korczynski ◽  
R. Krenke ◽  
A. Fangrat ◽  
W. Kupis ◽  
T. M. Orlowski ◽  
...  

2018 ◽  
Vol 11 (3) ◽  
pp. 193-201
Author(s):  
Md all Rayhan ◽  
Viktor Viktorovich Bulynin ◽  
Alexander Ivanovich Zhdanov ◽  
Yuri Alexandrovich Parkhisenko ◽  
Borich Efimovich Leibovich

Relevance. Spontaneous esophageal rupture (Boerhaave syndrome) is observed relatively rare ranging from 2.9% to 12% of all cases of damage of the esophagus. Today, there is not any categorical opinion about the effectiveness of different treatments among surgeons, there are not any single algorithms for the diagnosis and evaluation of treatment. Spontaneous esophageal rupture is a real threat for the life of patient: mortality up to 75% in the prehospital period and more than 90% in the postoperative period, and depends on the time interval between the rupture of the esophageal wall and the operation time, and also complications (suppurative esophagitis, suppurative mediastinitis, bilateral suppurative lobular pneumonia, sepsis). Purpose. To improve results of surgical treatment of patients with spontaneous esophageal rupture using the results obtained in the experiment. Materials and methods. Since 2004 till 2017 twelve patients with spontaneous esophageal rupture were treated in our hospital. Ways of treatment of lower third of esophageal rupture: drainage of pleural cavity – 2 patients; closure of the defect, fundoplication with covered stitches by the bottom of the stomach – 2 patients; perforated hole was not sutured, and a cuff, covering the perforation, was formed from the bottom of the stomach (fundoplication by Chernousov) – 8 patients. These methods of surgical treatment were applied in the experiments on 120 rats. Each group consisted of 40 rats. Results and discussion. The pleural cavity drainage, lethality – 1 (50%) patient. The suturing of the defect of the esophageal walls, the fundoplication with the stitches, covered by the bottom of the stomach, failure of stitches – 2 patients, lethality – 1 (50%) patients. The perforated hole was not sutured, and the cuff was shaped from the bottom of the stomach, covering the perforation. Lethality – 2 (25%) patients, caused by bilateral pneumonia in contrast to progressive sepsis. Other patients operated on this method didn’t have any failure of stiches. In the experiment: in the 1st group the failure of stitches was 87.5% and lethality – 100%; in the 2nd group the failure of stitches was 85% and lethality – 100%; in the 3rd group  there was not any failure of stitches, lethality – 17.5%. Conclusions. The most effective method of treatment is the restoration of rupture esophagus without suturing, and forming a cuff from the bottom of the stomach, covering the perforation. Drainage of pleural cavity and nutrition through a nasogastric tube.


2020 ◽  
Vol 7 (10) ◽  
pp. 3442
Author(s):  
Eduard A. Galliamov ◽  
Igor V. Semenyakin ◽  
Sergey A. Erin ◽  
Evgeniy A. Kytirev ◽  
Grigorii Y. Gololobov ◽  
...  

Spontaneous rupture of the esophagus, Boerhaave syndrome, is a rare pathology and emergency condition for the patient. Patient, 63-year-old, on the 6th day of the disease falls into the clinic, where a Boerhaave syndrome was diagnosed. Laparoscopic surgery was performed. Sanitation and drainage of the mediastinum, suturing of the perforation hole were performed. After the operation, а positive response to treatment was observed. A group of authors believes that a minimally invasive approach to the treatment of spontaneous esophageal rupture is the alternative method for patients with severe somatic status and a small perforated opening of the esophagus.


Medicine ◽  
2018 ◽  
Vol 97 (48) ◽  
pp. e13422
Author(s):  
Feiyun He ◽  
Mugen Dai ◽  
Jiwang Zhou ◽  
Jiansheng He ◽  
Bin Ye

Sign in / Sign up

Export Citation Format

Share Document