Successful primary repair in a late presentation of Boerhaave’s syndrome. Case report


COD: 12_04_2021_3562_ep Categorie: , ,

Merab A. Kiladze, Temur Imnadze, Shota Benidze, Otar Kepuladze

Ann Ital Chir, 2021; 10 – April 12
Online Epub

La mia nuova descrizione qui!

Price of a print issue €25.00

We present a case of Boerhaave’s syndrome successfully managed by open transabdominal approach 48 h after the acute
event. A 55-year-old female presented with hydropneumothorax, chest pain, dyspnea, vomiting and fever. The urgent
radiologic (X-ray, CT) and endoscopic study revealed the large defect of left posterolateral wall of esophagus with extrusion
of fluid and gastric contents into the mediastinum and left chest. Emergency intercostal drainage insertion was performed
and patient was transferred to our hospital. By open transabdominal approach after the wide sagittal diaphragmotomy
the primary repair over the nasogastric tube using simple interrupted sutures (Vicryl 3/0) and partial fundoplication
to cover the suture line was performed. Chest drainage tubes was then positioned near and parallel to the
repaired esophagus and feeding jejunostomy was then performed for enteral nutrition. On the seventh postoperative day,
a gastrografin swallow showed a small leak in the repair site without any collection, which was healed after 1,5 month
of conservative treatment. We consider, that proactive surgical approach with primary surgical repair is still possible and
feasible option despite the late presentation of Boerhaave’s syndrome.