Conservative treatment of Boerhaave's syndrome in an octogenarian complicated with late distal esophageal stenosis and successfully treated by stent placement

Cir Cir. 2021;89(S1):23-27. doi: 10.24875/CIRU.20000882.

Abstract

An 83-year-old female patient presented to the Emergency Department with shortness of breath, difficulty swallowing and left-sided chest pain following a vomiting attempt. A rupture in the left lower third of the esophagus, with hydropneumothorax, pneumomediastinum, and subcutaneous emphysema was revealed by chest X-ray, thoracic computed tomography scan, and contrast esophagography. The patient was successfully treated conservatively with closed thoracostomy, intravenous fluids, parenteral nutrition, and broad-spectrum antibiotics coverage. Following the successful conservative treatment, the patient developed a distal esophageal stenosis which was treated with an intra-esophageal self-expanding stent.

Una paciente de 83 años acudió al Servicio de Urgencias con disnea, dificultad para tragar y dolor en el lado izquierdo del pecho tras un intento de vómito. Una rotura en el tercio inferior izquierdo del esófago, con hidroneumotórax, neumomediastino y enfisema subcutáneo fue revelada por radiografía de tórax, tomografía computarizada de tórax y esofagografía con contraste. El paciente fue tratado con éxito de manera conservadora con toracostomía cerrada, líquidos intravenosos, nutrición parenteral y cobertura de antibióticos de amplio espectro. Tras el exitoso tratamiento conservador, el paciente desarrolló una estenosis esofágica distal que fue tratada con un stent autoexpandible intraesofágico.

Keywords: Boerhaave’s syndrome; Esophageal perforation; Esophageal rupture; Esophageal tear; Esophagus; Spontaneous rupture.

Publication types

  • Case Reports

MeSH terms

  • Aged, 80 and over
  • Conservative Treatment
  • Esophageal Perforation* / complications
  • Esophageal Perforation* / diagnostic imaging
  • Esophageal Perforation* / surgery
  • Esophageal Stenosis* / complications
  • Esophageal Stenosis* / surgery
  • Female
  • Humans
  • Mediastinal Diseases
  • Rupture, Spontaneous
  • Stents

Supplementary concepts

  • Boerhaave syndrome