Published online Sep 21, 2014. doi: 10.3748/wjg.v20.i35.12696
Revised: April 22, 2014
Accepted: July 24, 2014
Published online: September 21, 2014
Boerhaave’s syndrome refers to the spontaneous transmural rupture of the esophagus. Primary repair may be performed in patients who present within 24 h of perforation, and such cases have the best outcomes as most complications have not yet developed. However, the treatment of late perforations remains controversial. Various approaches and strategies to repair late perforations have been described in the literature, but there is no uniform approach. We present a case of Boerhaave’s syndrome in which the patient underwent surgical repair 48 h after the acute event and was subsequently treated successfully. The initial approach included direct esophageal repair, a drainage series, and nutritional support via a feeding jejunostomy. Although the repair site was subsequently disrupted, the patient showed complete healing of the perforation after three weeks. We consider that our surgical treatment strategy is safe and technically feasible, and appears to be a promising alternative approach for the treatment of patients with late Boerhaave’s perforation.
Core tip: Boerhaave’s syndrome refers to the spontaneous transmural rupture of the esophagus. The successful treatment of Boerhaave’s syndrome remains very challenging for surgeons, especially cases involving late perforations. Various strategies to repair late perforations have been previously described, but there is no uniform approach. We present a successful surgical strategy in a case of Boerhaave’s syndrome with late perforation, which involved surgical repair of the perforation and a series of drainage procedures. We consider that our strategy is safe and technically feasible, and appears to be a promising alternative approach for late Boerhaave’s perforation.