Third time recurrent Boerhaave's syndrome: a case report.

Area of Science:

• Gastroenterology
• Thoracic Surgery
• Medical Case Reports

Background:

• Boerhaave's syndrome, an esophageal rupture, is rare with a prognosis dependent on early diagnosis and treatment.
• Recurrent effort ruptures are exceptionally uncommon, with limited documentation in medical literature.
• This report presents a unique case of a third esophageal rupture, previously unreported.

Observation:

• A 60-year-old male with a history of two prior esophageal ruptures presented with a third episode.
• Previous treatments included primary repair via thoracotomy/laparotomy and endoscopic stent placement.
• The current episode was successfully managed solely with endovascular vacuum-assisted closure therapy.

Findings:

• The third instance of Boerhaave's syndrome in this patient was effectively treated with endovascular vacuum-assisted closure.
• Individualized treatment is crucial for recurrent esophageal ruptures, focusing on early diagnosis, drainage, and repair.
• Endoscopic treatments like stent placement and vacuum-assisted closure are valuable for complex esophageal conditions.

Implications:

• This case underscores the potential for recurrent esophageal rupture and the evolving treatment landscape.
• Advanced endoscopic techniques offer less invasive options for managing complex esophageal perforations.
• Modern esophageal centers must be equipped with diverse surgical and endoscopic capabilities to address rare and complex cases.