Spontaneous Ruptur of the Esophagus

Bolooki, Hooshang; Anderson, ID; Garcia-Rivera, C; Jude, James R.

doi:10.1097/00000658-197108000-00020

Cited by 22 publications

(5 citation statements)

References 6 publications

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“…In determining treatment, the general condition of the patient, the degree of contamination and the state of the esophagus around the perforation represent the most important factors. A consensus has been reached that esophageal perforation should be repaired and thoracic and mediastinal drainage should be performed when diagnosis is achieved within 24 h [ 4 , 5 , 6 , 7 , 8 ]. In contrast, the treatment for cases diagnosed more than 24 h after onset has not reached a consensus.…”

Section: Discussionmentioning

confidence: 99%

Successful Treatment of Septic Shock due to Spontaneous Esophageal Perforation 96 Hours after Onset by Drainage and Enteral Nutrition

Yamashita

Takeno

Yamana

et al. 2014

Case Rep Gastroenterol

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Spontaneous esophageal perforation is relatively uncommon, but carries a high mortality rate if diagnosis or treatment is delayed. We report the case of a 68-year-old man with spontaneous esophageal perforation who was successfully treated over 96 h after onset by thoracic drainage and jejunostomy for enteral nutrition. He vomited after drinking alcohol, soon followed by epigastralgia. Heart failure was suspected on admission to another hospital. Spontaneous esophageal perforation was diagnosed 48 h after admission. Chest tube drainage was performed, but his general condition deteriorated and he was transferred to our hospital. Emergent surgery was performed and esophageal perforation combined with pyothorax and mediastinitis was identified on the left side of the lower esophagus. The left thoracic cavity was rinsed and thoracic drainage was performed. Feeding jejunostomy was performed for postoperative enteral nutrition. Effective drainage and sufficient nutrition management appear extremely valuable in treating spontaneous esophageal perforation.

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Section: Discussionmentioning

confidence: 99%

Successful Treatment of Septic Shock due to Spontaneous Esophageal Perforation 96 Hours after Onset by Drainage and Enteral Nutrition

Yamashita

Takeno

Yamana

et al. 2014

Case Rep Gastroenterol

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“…Since then a number of successfully treated cases have been reported, but lethal outcomes remain common because of failure to make an early diagnosis. Review of the literature suggests that the mortality remains unacceptably high 2–4 . In Taiwan, cases of oesophageal rupture are not common, 5 and we have undertaken an analysis of clinical data and compare our results with other reports and point out some different experiences.…”

mentioning

confidence: 84%

Clinical Challenge — An Experience of Spontaneous Transmural Rupture of the Oesophagus in Taiwan

et al. 1996

Int J Clinical Practice

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SUMMARY In Taiwan, spontaneous oesophageal rupture is uncommon but the outcome is often lethal because of failure to make an early diagnosis. We have analysed clinical data, management and the risk factors that affect mortality for a consecutive series of 11 patients who had spontaneous oesophageal perforation between 1983 and 1994. The primary symptom was chest or abdominal pain, which was present in 100% of patients; 91% of patients had abnormal chest x‐ray (63% pleural effusion, 46% pneumomediastinum, 37% subcutaneous emphysema). In our series of patients the lower thoracic area was the most common location of the perforation (80% of patients. There were no statistically significant differences in mortality due to age, underlying disease, perforation size, location or surgical methods. A poor prognosis seems to be correlated with the time elapsed between the perforation and treatment (especially if >72 hours) (p<0.05), respiratory failure (p<0.05), and heavy contamination of the mediastinum (p<0.05). The clinical findings depend on the location and time of perforation. History, chest x‐ray and oesophagogram are the most useful diagnostic tools. Early diagnosis and treatment are mandatory for these patients.

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“…In the year 1724, Hermann Boerhaave reported a case of a Dutch admiral who died due to spontaneous rupture of the esophagus following vomiting. He also gave a detailed description of the symptoms and the pathophysiological findings defining the condition known as Boerhaave's syndrome [[1], [2], [3]].…”

Section: Introductionmentioning

confidence: 99%

Boerhaave's syndrome with late presentation. Experience in an Argentine single center: Case series

Hernández

Horiuchi

Rivaletto

et al. 2019

Annals of Medicine and Surgery

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Background In the year 1724, Hermann Boerhaave reported a case of a Dutch admiral who died due to spontaneous rupture of the esophagus following vomiting. The aim of this retrospective study is to analyze the therapeutic modality, morbidity and mortaliy of a group of patients with spontaneous esophageal rupture treated in our hospital. Methods Ten patients were treated from March 1990 to August 2016. Seven patients were males and three were females. The age range was, 52–72 years, with an average of 66.2 years. In four patients, the diagnosis and posterior treatment were performed within 24 h (Group I) and the remaining six patients after 24 h (Group II). Results The mean hospital stay was 36.6 days (range 17–62 days). The mortality rate was 50%, which was due to septic shock and the morbidity of patients who survived was 40% due to pneumonia in one case and fistula in another. Discussions This condition has a high mortality rate with a lethality that depends on the time between recognition of symptoms and proper surgical treatment.

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Spontaneous Ruptur of the Esophagus

Cited by 22 publications

References 6 publications

Successful Treatment of Septic Shock due to Spontaneous Esophageal Perforation 96 Hours after Onset by Drainage and Enteral Nutrition

Successful Treatment of Septic Shock due to Spontaneous Esophageal Perforation 96 Hours after Onset by Drainage and Enteral Nutrition

Clinical Challenge — An Experience of Spontaneous Transmural Rupture of the Oesophagus in Taiwan

Boerhaave's syndrome with late presentation. Experience in an Argentine single center: Case series

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