[Surgical treatment of Boerhaave's syndrome]

The authors treated four patients with spontaneous oesophageal rupture between 1995 and 1999. The interval from injury to surgical treatment was less than 24 h in two cases, and longer than 24 h in the other two cases. The surgical treatment was primary closure of the rupture and mediastinal drainage with gastrostomy within 24 h after the onset. Septic complications occurred in lately presented patients. In these cases, the surgical treatment consisted of oesophagectomy, mediastinal drainage and feeding gastrostomy. The alimentary tract was reconstructed with interposed ileocolon eight weeks later. Each patients was fully recovered. The authors underline the importance of early diagnosis which obviously determine the prognosis and the choice of surgical treatment. Primary repair is proposed after early diagnosis, however oesophageal resection is recommended 24 h after the injury.