Single Procedure Esophageal Bypass: A Valid Option In Delayed Surgical Intervention For Complicated Esophageal Perforation

Abstract

We present a case report of Boerhaave syndrome or spontaneous post-emetic rupture of the esophagus complicated with an esophagopleural fistula of which the diagnosis was missed at the initial presentation in the emergency. Surgical intervention was delayed for more than two weeks until the esophageal perforation was recognized. The patient was optimized for surgery and a single-stage esophageal bypass surgery was done where the esophagus was left in situ, the stomach was pulled up through the substernal route and a cervical esophagogastric anastomosis was made to restore the gastrointestinal continuity; thus avoiding the morbidity associated with an esophagostomy and a second procedure for delayed reconstruction.