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[Boerhaave's syndrome. Emergency surgery]

A Spivach, B Borea, M Casagrande

    Minerva Medica
    |January 28, 1981
    PubMed
    Summary

    This case report highlights Boerhaave's syndrome, a spontaneous esophageal rupture, in an alcoholic patient. Early recognition of pain, shock, and emphysema is crucial for surgical intervention.

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    Area of Science:

    • Gastroenterology
    • Thoracic Surgery
    • Emergency Medicine

    Context:

    • Spontaneous rupture of the esophagus, known as Boerhaave's syndrome, is a rare and life-threatening condition.
    • This case involves a 66-year-old male with a history of alcoholism presenting with severe symptoms.

    Purpose:

    • To report a case of Boerhaave's syndrome.
    • To emphasize the diagnostic triad and the importance of prompt surgical management.

    Summary:

    • The patient presented with epigastric pain, vomiting, retrosternal pain radiating to the back, and shock.
    • Radiographic findings included increased pulmonary hypodiaphania, left pleural effusion, and cervicothoracic subcutaneous emphysema.
    • Emergency thoracotomy with esophageal repair and drainage was performed, but the patient succumbed to bronchopulmonary complications on day 10.

    Impact:

    • The Authors propose that the combination of pain, shock, and mediastinal/thoracic/cervical emphysema is pathognomonic for Boerhaave's syndrome.
    • This recognition is vital for surgeons in emergency settings to ensure timely diagnosis and treatment.
    • Prompt surgical intervention is critical for improving outcomes in Boerhaave's syndrome.

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