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

Daniel N Velasco Hernández,Héctor R Horiuchi,Fidelio Farina,Matías Viscuso,Lucas A Rivaletto

doi:10.1016/j.amsu.2019.07.023

Daniel N Velasco Hernández, Héctor R Horiuchi + Show 3 more

Open Access

https://doi.org/10.1016/j.amsu.2019.07.023

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Abstract

BackgroundIn 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.MethodsTen 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).ResultsThe 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.DiscussionsThis condition has a high mortality rate with a lethality that depends on the time between recognition of symptoms and proper surgical treatment.

Highlights

In the year 1724, Hermann Boerhaave reported a case of a Dutch admiral who died due to spontaneous rupture of the esophagus following vomiting
This condition consists of a transmural laceration occurring most frequently at the left posterolateral aspect of the distal esophagus due to a sudden increase intraluminal pressure. Given that this condition is difficult to diagnose and that it is considered one of the most lethal gastrointestinal perforations, it is a topic under continuous revision in the literature [4,5]. The purpose of this retrospective study is to analyze a group of patients with spontaneous esophageal rupture by considering the time elapsed until reaching proper diagnosis for the choice of surgical treatment, and the morbidity and mortality rate
From March 1990 through March 2016, 10 patients were treated for spontaneous rupture or Boerhaave's syndrome

Summary

Introduction

Given that this condition is difficult to diagnose and that it is considered one of the most lethal gastrointestinal perforations, it is a topic under continuous revision in the literature [4,5] The purpose of this retrospective study is to analyze a group of patients with spontaneous esophageal rupture by considering the time elapsed until reaching proper diagnosis for the choice of surgical treatment, and the morbidity and mortality rate. 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. 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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Results

Conclusion