Abstract
BackgroundBoerhaave’s syndrome involves a sudden elevation in the intraluminal pressure of the esophagus, causing a transmural perforation. It is associated with high morbidity and mortality. Its treatment is challenging, and early surgical intervention is the most crucial prognostic element.Case presentationWe present a case of a 32 year-old male who presented after severe emesis with an acute onset of epigastric pain. He was diagnosed with Boerhaave’s syndrome. Displaying signs of shock mandated immediate surgical exploration with laparoscopic primary repair.ConclusionThe golden period of the first 24 hrs of the event still applies to cases of esophageal perforation. The scarcity of these cases makes a comparison between the various treatment methods difficult. Our data support the use of laparoscopic intervention with primary repair as the mainstay of treatment for the management of esophageal perforation.
Highlights
Boerhaave’s syndrome involves a sudden elevation in the intraluminal pressure of the esophagus, causing a transmural perforation
The golden period of the first 24 hrs of the event still applies to cases of esophageal perforation
Our data support the use of laparoscopic intervention with primary repair as the mainstay of treatment for the management of esophageal perforation
Summary
The golden period of the first 24 h of insult still applies for cases of esophageal perforation. The rarity of these cases makes a comparison between the various methods of treatment difficult. The data presented support the use of laparoscopic operative intervention with primary repair as the mainstay of management of similar esophageal pathology, which showed success even with late presentations. The authors further emphasize the importance of involving a multidisciplinary team in the management of such challenging cases. This includes Intensive care physician, Thoracic surgeon, and laparoscopic surgeon.
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