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Boerhaave Syndrome – over 290 years of surgical experiences. Can the disorder recur?

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Rokicki M., Rokicki W., Moj M., Bsoul T., Rydel M.

Polish Journal of Surgery

2019

vol. 91(3)

27-29

Spontaneous perforation of the esophagus (Boerhaave syndrome) is a rare disease that poses a serious surgical challenge. The analysis of literature concerning the Boerhaave syndrome reveled cases of recurrent spontaneous perforation of the esophagus. The incidental nature of this condition calls for more accurate assessment of all such cases. The authors made a detailed evaluation of the data obtained from eight reports of recurrent Boerhaave syndrome. The data is presented as a summary table comparing the clinical course and outcomes of patients with the primary Boerhaave syndrome as well as recurrent Boerhaave syndrome.

Oesophageal perforation – therapeutic and diagnostics challenge. Retrospective, single-center case report analysis (2009–2015)

100%

Misiak P., Jabłoński S., Piskorz Ł., Dorożała L., Terlecki A., Wcisło S.

Polish Journal of Surgery

2017

vol. 89(4)

1-4

Background: Esophageal perforation is a life-threatening condition of a complex etiology. No clear guidelines are available regarding the management of this condition. In this study, we review publications related to esophageal perforation, and analyze patients treated for this condition at our Department of Thoracic, General and Oncological Surgery. Objective: The objective of the study was to retrospectively assess and analyze management methods for esophageal perforations of different etiologies. All patients were treated in the Department of Thoracic, General and Oncological Surgery in years 2009-2015. Patients with perforations resulting from post-operational leaks within surgical anastomoses were excluded from the study. Material, methods, results: The analysis involved a total of 16 cases of esophageal ruptures. All cases were treated in years 2009-2015. Patients with perforations resulting from postoperative leaks within surgical anastomoses following elective surgeries for either oncological or non-oncological causes were excluded. The most common reason for esophageal rupture was iatrogenic injury (7 cases, 44%). Other causes included Boerhaave syndrome (5 cases, 31.2%), blunt trauma (2 cases, 12.5%), abscess perforation (1 case, 6.2%), and ulcer perforation (1 case, 6.2%). Ten patients underwent surgery, and the rest underwent esophageal prosthesis placement, of whom 2 cases required drainage of the mediastinum and pleural cavity. The mortality rate in the study group was 9/16 cases (56.2%). Conclusions: Esophageal perforation poses a significant interdisciplinary challenge regarding diagnostic workup, selection of treatment methods, and management of potential postoperative complications. This retrospective study was conducted in a single center. Although the analyzed period was long, we found only 16 cases. In spite of a variety of etiologies present, we found several statistically significant results of potential clinical value. 1. Most perforations that are not diagnosed within 48 hours affected the lower part of the esophagus and presented with unclear symptoms and imaging findings 2. Delaying diagnosis and treatment beyond 24 hours was associated with a higher mortality rate.

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2 Polish Journal of Surgery

1 2019

1 2017

1 Bsoul T.

1 Dorożała L.

1 Jabłoński S.

1 Misiak P.

1 Moj M.

1 Piskorz Ł.

1 Rokicki M.

1 Rokicki W.

1 Rydel M.

1 Terlecki A.

1 Wcisło S.

Search results

Boerhaave Syndrome – over 290 years of surgical experiences. Can the disorder recur?

Oesophageal perforation – therapeutic and diagnostics challenge. Retrospective, single-center case report analysis (2009–2015)