Authors
Demaldinov D.A.1, Mustafin R.D.1, Kurtusunov B.T.1, Rozhkova S.V.2
1 Astrakhan State Medical University, Astrakhan, Russia
2 Pathoanatomical bureau, Astrakhan, Russia
Abstract
Two clinical cases of surgical tactics options for Burhaаve syndrome (spontaneous perforation of the esophagus) are presented. The assessment of the status of patients, the nature of interventions, the results of histological examination and the outcomes of the disease was carried out.
In both cases, the reason for hospitalization in the thoracic department was a spontaneous rupture of the esophagus, complicated by mediastinitis and pleural empyema.
The first patient, 59 years old, underwent esophageal extirpation with the imposition of gastro- and esophagostomy. Сlinical recovery has been achieved with the reconstructive surgery was performed. The second patient, 69 years old, underwent conservative treatment. On the 7th day, there was an arrosive bleeding. A thoracolaparotomy and suturing of the esophageal defect were urgently performed. In the postoperative period, there was a progressive deterioration with the death for the esophageal sutures leak and coronary syndrome.
Keywords: Boerhaave syndrome, case reports, esophageal perforation, esophagectomy, histological examination.
References
1. Haba Y, Yano S, Akizuki H, et al. Boerhaave syndrome due to excessive alcohol consumption: two case reports. Int J Emerg Med. 2020; 13(1): 56. doi: 10.1186/s12245-020-00318-5.
2. Cuccì M, Caputo F, Fraternali Orcioni G, et al. Transition of a Mallory-Weiss syndrome to a Boerhaave syndrome confirmed by anamnestic, necroscopic, and autopsy data: A case report. Medicine (Baltimore). 2018; 97(49): e13191. doi: 10.1097/MD.0000000000013191.
3. Kimura-Kataoka K, Fujihara J, Kurata S, et al. An autopsy case of spontaneous esophageal perforation (Boerhaave syndrome). Leg Med (Tokyo). 2016; 23:5-9. doi: 10.1016/j.legalmed.2016.08.009.
4. Han D, Huang Z, Xiang J, et al. The Role of Operation in the Treatment of Boerhaave’s Syndrome. Biomed Res Int. 2018; 2018: 8483401. doi: 10.1155/2018/8483401.
5. Mureșan M, Mureșan S, Balmoș I, Sala D, Suciu B, Torok A. Sepsis in Acute Mediastinitis – A Severe Complication after Oesophageal Perforations. A Review of the Literature. J Crit Care Med (Targu Mures). 2019; 5(2): 49-55. doi: 10.2478/jccm-2019-0008.
6. Asner TV, Kalyagin AN, Kiseleva ER, et al. The difficulties of diagnostics of diseases of the oesophagus: spontaneous rupture of the oesophagus (Boerhaave’s syndrome). Doctor. Ru. 2022; 21(6): 41-44. (In Russ.) doi: 10.31550/1727-2378-2022-21-6-41-44.
7. Sohda M, Saeki H, Kuwano H, et al. Current status of surgical treatment of Boerhaave’s syndrome. Esophagus. 2022; 19(1): 175-181. doi: 10.1007/s1038 -021-00858-6.
8. Ariza-Traslaviña J, Caballero-Otálora N, Polanía-Sandoval CA, еt al. Two-staged surgical management for complicated Boerhaave syndrome with esophagectomy and deferred gastroplasty: A case report. Int J Surg Case Rep. 2023; 103: 107881. doi: 10.1016/ j.ijscr.2023.107881.
9. Shevchenko YuL, Susov RP. Postoperative infectious and inflammatory complications in cardiothoracic surgery. Bulletin of the NMHC named after N.I. Pirogov. 2022; 17(1): 84-89. (In Russ.) doi: 10.25881/ 20728255_2022_17_1_84.
10. Shen G, Chai Y, Zhang GF. Successful surgical strategy in a late case of Boerhaave’s syndrome. World J Gastroenterol. 2014; 20(35): 12696-12700. doi: 10.3748/wjg.v20.i35.12696.
11. Pezzetta E, Kokudo T, Uldry E, et al. The surgical management of spontaneous esophageal perforation (Boerhaave’s syndrome) ‒ 20 years of experience. Biosci Trends. 2016; 10(2): 120-124. doi: 10.5582/bst.2016.01009.
12. Wahed S, Dent B, Jones R, Griffin SM. Spectrum of oesophageal perforations and their influence on management. Br J Surg. 2014; 101(1): e156-e162. doi: 10.1002/bjs.9338.
13. Otdelnov LA, Malyshev IO. Boerhaave’s syndrome in general surgery: the realities and prospects. Kursk Scientific and Practical Bulletin «Man and His Health». 2019; 1: 23-32. (In Russ.) doi: 10.21626/vestnik/ 2019-1/03.
14. Veltri A, Weindelmayer J, Alberti L, at al. Laparoscopic transhiatal suture and gastric valve as a safe and feasible treatment for Boerhaave’s syndrome: an Italian single center case series study. World J Emerg Surg. 2020; 15(1): 42. doi: 10.1186/s13017-020-00322-3.
15. Sudarshan M, Elharram M, Spicer J, at al. Management of esophageal perforation in the endoscopic era: Is operative repair still relevant? Surgery. 2016; 160(4): 1104-1110. doi: 10.1016/j.surg.2016.07.025.
16. Zimmermann M, Hoffmann M, Jungbluth T, et al. Predictor of morbility and mortality and mortality in esophageal perforation: retrospective stady of 80 patiens. Scand J Surg. 2017; 106(2): 126-132. doi: 10.1177/14574969166540971.
