Abstract
BackgroundSpontaneous esophageal rupture, also called Boerhaave’s syndrome, is relatively uncommon but may result in high morbidity and mortality. Synchronous presentation of spontaneous esophageal rupture and perforated peptic ulcer was rare and may contribute to the difficulty of achieving a correct diagnosis.Case presentationWe reported two patients with spontaneous esophageal rupture following perforated peptic ulcer. Both patients were successfully treated with thoracoscopic primary repair of esophageal rupture. The first patient underwent peptic ulcer repair via laparotomy. The second patient underwent laparoscopic duodenorrhaphy. Both patients resumed oral intake smoothly and were discharged uneventfully.ConclusionMinimally invasive approaches are safe and feasible for both esophageal rupture and perforated peptic ulcer in patients diagnosed within 24 h and without shock.
Highlights
Spontaneous esophageal rupture, called Boerhaave’s syndrome, is relatively uncommon but may result in high morbidity and mortality
Minimally invasive approaches are safe and feasible for both esophageal rupture and perforated peptic ulcer in patients diagnosed within 24 h and without shock
* Correspondence: 144474@cch.org.tw 1Division of Thoracic Surgery, Department of Surgery, Changhua Christian Hospital, No 135 Nanxiao St., Changhua City, Changhua County 500, Taiwan Full list of author information is available at the end of the article rupture and perforated peptic ulcer may contribute to the difficulty of achieving a correct diagnosis, and only a few cases have been reported in the literature [2,3,4]
Summary
Spontaneous esophageal rupture, called Boerhaave’s syndrome, is relatively uncommon but may result in high morbidity and mortality. Conclusion: Minimally invasive approaches are safe and feasible for both esophageal rupture and perforated peptic ulcer in patients diagnosed within 24 h and without shock. Missed diagnosis as myocardial infarction, pancreatitis, and peptic ulcer perforation were reported due to similarities in symptoms [1]. The primary layer-by-layer repair of injured esophagus following meticulous removal of the devitalized tissue, minimizing contamination by decortication of thoracic empyema, sepsis control, and nutritional support are all keys to success.
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