Salvage Intraluminal Endoscopic Vacuum Therapy for Stent Failure in Late-Presenting Boerhaave Syndrome

Abstract

A 57-year-old alcoholic patient with chest pain for >48 hours was admitted to our intensive care unit because of full-blown sepsis necessitating vasopressor support and orotracheal intubation. Chest drainage indicated high-amylase pleural effusion. Methylene blue injected through a nasogastric tube was seen exiting through the chest drain, and endoscopy confirmed subacute perforation on a background of “black esophagus” above the esophagogastric junction. A 26 × 100 mm fully covered self-expanding metal stent was placed at bedside; however, after stent extraction 3 weeks later the perforation persisted (Figure A).