Effort rupture of the esophagus, or Boerhaave syndrome, is a spontaneous perforation of the esophagus that results from a sudden increase in intraesophageal pressure combined with negative intrathoracic pressure (eg, severe straining or vomiting). Symptoms of rupture of the esophagus include chest pain, abdominal pain, vomiting, vomiting blood, low blood pressure, and fever
The diagnosis of Boerhaave's syndrome is suggested on the plain chest radiography and confirmed by chest CT scan. The diagnosis of esophageal perforation could also be confirmed by water-soluble contrast esophagram (Gastrografin), which reveals the location and extent of extravasation of contrast material.
Treatment is typically tailored to the patient’s presentation, the type, and extent of the rupture, the time to diagnosis, and the viability of the esophageal wall. Three common treatment options include conservative, endoscopic, or surgical. The mainstay of treatment includes volume replacement, broad-spectrum antibiotic coverage, and surgical evaluation. Surgical intervention includes primary esophageal repair through open thoracotomy vs. VATS with fundic reinforcement, which is the gold standard within the first twenty-four hours. Endoscopic placement of stents has been used to prevent fistula formations or seal esophageal leaks in both patients with delayed diagnoses and those with the early diagnosis without widespread contamination. Conservative measurements are usually reserved for small or contained ruptures.
Every examination and operation related to the disease should be performed by a properly equipped hospital with the latest medical technology and professional academic medical staff. The Turkish Health Group will definitely direct you to the hospitals with the most modern medical equipment and professional medical staff related to your disease. Contact us for more information and a free second medical reference from a professional Turkish doctors.