Dataset Information

Boerhaave's syndrome with late presentation. Experience in an Argentine single center: Case series.

ABSTRACT:

Background

In the year 1724, Hermann Boerhaave reported a case of a Dutch admiral who died due to spontaneous rupture of the esophagus following vomiting. The aim of this retrospective study is to analyze the therapeutic modality, morbidity and mortaliy of a group of patients with spontaneous esophageal rupture treated in our hospital.

Methods

Ten patients were treated from March 1990 to August 2016. Seven patients were males and three were females. The age range was, 52-72 years, with an average of 66.2 years. In four patients, the diagnosis and posterior treatment were performed within 24 h (Group I) and the remaining six patients after 24 h (Group II).

Results

The mean hospital stay was 36.6 days (range 17-62 days). The mortality rate was 50%, which was due to septic shock and the morbidity of patients who survived was 40% due to pneumonia in one case and fistula in another.

Discussions

This condition has a high mortality rate with a lethality that depends on the time between recognition of symptoms and proper surgical treatment.

SUBMITTER: Velasco Hernandez DN

PROVIDER: S-EPMC6651841 | biostudies-literature | 2019 Sep

REPOSITORIES: biostudies-literature

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Publications

Boerhaave's syndrome with late presentation. Experience in an Argentine single center: Case series.

Velasco Hernández Daniel N DN Horiuchi Héctor R HR Rivaletto Lucas A LA Farina Fidelio F Viscuso Matías M

Annals of medicine and surgery (2012) 20190713

<h4>Background</h4>In the year 1724, Hermann Boerhaave reported a case of a Dutch admiral who died due to spontaneous rupture of the esophagus following vomiting. The aim of this retrospective study is to analyze the therapeutic modality, morbidity and mortaliy of a group of patients with spontaneous esophageal rupture treated in our hospital.<h4>Methods</h4>Ten patients were treated from March 1990 to August 2016. Seven patients were males and three were females. The age range was, 52-72 years, ...[more]

PMID: 31367374

Similar Datasets

Project description:BACKGROUND:Boerhaave's syndrome (BS) is a rare life-threating condition with poor prognosis. Unfortunately, due to its very low incidence, no clear evidences or definitive guidelines are currently available: in detail, surgical strategy is still a matter of debate. Most of the case series reports thoracic approach as the most widely used; conversely, transhiatal abdominal management is just described in sporadic case reports. In our center, the laparoscopic approach has been adopted for years: in the present study, we aim to show his feasibility by reporting the outcomes of the largest clinical series available to date. METHODS:Clinical records of patients admitted for BS to the General and Upper GI Surgery Division of Verona from February 2014 to December 2019 were retrospectively collected. Clinico-pathological characteristics, preoperative workup, surgical management, and outcomes were analyzed. RESULTS:Seven patients were admitted; epigastric/thoracic pain and vomiting were the most frequent symptoms at diagnosis. Laboratory findings were not specific; conversely, radiological imaging always revealed abnormal findings: particularly, CT had excellent sensitivity in detecting signs of esophageal perforation. All but one case had diagnostic workup and received surgery within 24?h. Every patient had laparoscopic transhiatal direct suture and gastric valve; 2 patients (28.6%) also needed a thoracoscopic toilette. Postoperative complications occurred in 4 patients (57%), but in only two of them (29%), the complication was severe according to Clavien-Dindo classification (both received thoracentesis or thoracic drainage for pleural effusion). Of note, no cases of postoperative esophageal leak were recorded. Postoperative mortality was 14% due to one patient who died for cardiovascular complications. Most of the patients (71.4%) were admitted to ICU after surgery (average length, 8.8?days); mean hospital stay was 14.7?days. No patients had readmissions. CONCLUSIONS:To our knowledge, this is the largest case series reporting laparoscopic management of BS. We show that laparoscopy is a safe and feasible approach associated with a shorter length of hospital stay when compared with clinical series in which thoracic approach had been chosen. Of note, laparoscopic management would be easily adopted by surgical centers treating benign gastro-esophageal junction entailing a proper management more widely.

Dataset Information

Boerhaave's syndrome with late presentation. Experience in an Argentine single center: Case series.

Background

Methods

Results

Discussions

Publications

Boerhaave's syndrome with late presentation. Experience in an Argentine single center: Case series.

Similar Datasets

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