• Korean Journal of Bronchoesophagology
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• v.18 no.1
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• pp.9-12
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• 2012

Boerhaave's syndrome is a very fatal condition occuring esophageal rupture during emesis and has the worst prognosis of the esophageal perforation. From May 2007 to March 2012 11 patients underwent surgical treatment for Boerhaave's syndrome at Inje University Sanggye Paik Hospital. There were 11 males whose mean age was 49.9 years ranging from 42 to 59. 2 cases of primary closure was performed and 9 cases of anastomosis using EEA (Esophago-Enteric Anastomisis) stapler. Mean operation time was 154.4 minutes and one patient who undergone primary repair died because of mediastinitis and sepsis on $35^{th}$ post-operative day. There was no leakage at other patients. Post-operative complication was one operative wound infection and one post-operative bleeding which was treated completely. Surgical treatment for Boerhaave's syndrome using EEA stapler is simple and effective technique but further studies with large number of cases should be carried out for better outcome.

• Journal of Chest Surgery
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• v.34 no.11
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• pp.879-882
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• 2001

advancement in the treatment of esophageal perforation due to the development of ICU care and antibiotics. There were controversies in the treatment of esophageal perforation when diagnosed after 24hrs. From 1995 to 2000, we performed a buttressed primary repair and mediastinal drainage in 6 Boerhaave\`s syndrome patients among 13 esophageal perforation patients. Two patients died(33%). They died because of pneumonia, ARDS and sepsis on 38th, 39th post-operative day respectively. Two patients had leak at the site of repair which was treated completely with conservative treatment. We report on the result of a buttressed primary repair and mediastinal drainage for 6 Boerhavve\`s syndrome patients.

• Journal of Chest Surgery
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• v.24 no.4
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• pp.371-375
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• 1991

Postemetic rupture of the esophagus is an intrathoracic catastrophe which is universally fatal if untreated immediately. We have experienced one case of Boerhaave`s syndrome at the Thoracic & Cardiovascular Surgery Yonsei University College of Medicine. He was 56 years old male who complained severe chest-pain, dyspnea with sudden vomiting after alcohol. Esophagogram showed barium leakage through rupture site on lower esophagus into left thoracic cavity. He had taken repair of the rupture site of lower esophagus and wrapping it with the body of the stomach wall because of relatively clean rupture margin even though 48 hours following the rupture. He has been uneventful in post-operative courses & he discharged with good conditions.

• Journal of Chest Surgery
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• v.23 no.5
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• pp.1035-1039
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• 1990

All 10 cases of spontaneous rupture of esophagus had violent vomiting as precursor. 9 patients were male, 1 case was female. Chief complaints were chest pain and dyspnea. Chest P \ulcornerA and esophagogram were mainly used as confirm diagnostic tool. Perforation sites of all cases were at distal esophagus near the G-E junction. 6 cases were received primary repair within 24 hrs, other cases were managed with surgical drainage after exclusion and diversion of esophagus. Empyema was the most frequent complication. Other complications were sepsis, pneumonia, leaking etc. Overall mortality rate was about 70.0%.

• Journal of Chest Surgery
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• v.41 no.6
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• pp.782-786
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• 2008

Dissection intramural hematoma of the esophagus (DIHO) is a rare, but well-documented condition that is part of the spectrum of, acute esophageal injuries; these include the more common Mallory-Weiss tear and Boerhaave's syndrome. This disorder is predominantly seen in women during their sixth or seventh decade and the disease has various etiologies, but the pathogenesis has yet to be clarified. The triad of symptoms for this disorder includes retrosternal pain, hematemesis and odynophagia. It is important to differentiate esophageal submucosal dissection form other disorders that have a similar appearance, such as Mallory-Weiss syndrome and esophageal perforation because the prognosis of DIHO is excellent with conservative therapy and these other diseases require surgical treatment. We report here on a case of a dissecting intramural hematoma of the esophagus that was preoperatively misdiagnosed as the submucosal tumor of the esophagus preoperatively, and it was confirmed by Video-assisted thoracic surgery.

• Journal of Chest Surgery
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• v.42 no.5
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• pp.657-661
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• 2009

Intramural esophageal dissection is a rare disorder that's characterized by a lengthy laceration between the mucosal and submucosal layers of the esophageal wall, and the esophageal wall is without perforation. The three different types of acute esophageal injury are a mucosal tear (Mallory-Weiss syndrome), full-thickness rupture (Boerhaave's syndrome) and intramural esophageal dissection. Most intramural esophageal dissections respond to conservative management with a very good prognosis. This rare condition should be considered in patients who present with acute chest pain, dysphagia or odynophagia, and particularly in the presence of a bleeding disorder or where there has been recent administration of antiplatelet medication, anticoagulantsorthrombolyticsto avoid inappropriate treatment with surgery. We present here a rare case of intramural dissection of the esophagus that occurred when the patient was taking anti platelet medication.

• Journal of Chest Surgery
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• v.23 no.3
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• pp.546-549
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• 1990

Spontaneous esophageal perforation occurred rarely but often lead to a high mortality and morbidity. We had experienced one case of spontaneous rupture of esophagus. A 52 - year old male patient was admitted to our hospital because of the chest pain and massive hematemesis after emetic strain. Esophagogram that taken at private clinic revealed leakage of dye into the right pleural space. Under the diagnosis of the thoracic esophageal perforation, two stage operation was planned because the size of perforation was large and pyothorax was developed on the right side. At first, exclusion and diversion of the esophagus were carried out. After six months, the esophageal reconstruction with left colon was performed.

• Korean Journal of Bronchoesophagology
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• v.5 no.1
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• pp.14-21
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• 1999

Perforating injury of the thoracic esophagus leads to an almost Immediate exposure of the mediastinum to both oral secretions and refluxed gastric contents. And necrotizing inflammatory response developed inevitably. So, without proper managements, mediastinitis results in severe dehydration or septic conditions, and consequently the life of the patient can be threaten. We experienced recently 4 cases of esophageal perforation. Three cases were Boerhaave's syndromes and the other one was instrumental perforation in patient with corrosive esophageal stricture. Curative surgical procedures were done in 3 cases and the drainage procedure was only possible in the other one due to hepatic failure. And the patient with the drainage management was dead.

• Journal of Chest Surgery
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• v.25 no.8
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• pp.812-818
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• 1992

The spontaneous rupture of the esophagus is an uncommon disease, but without early diagnosis and treatment, the mortality rate is high. This report is on the two cases treated at the Department of Thoracic and Cardiovascular Surgery, College of Medicine, Kyu-ngpook National University. The first patient, after heavy drinking, had vomiting followed by chest pain, dyspnea and subcutaneous emphysema. After diagnosis using an esophagogram, an operation was perfomed. About a 4cm rupture was found at the lower left part of the esophagus and was primarily sutured with the intercostal muscle. The patient was weaned from the ventilator after 40 hours. The second patient had symptoms the same as the first case. Six days after the app-earence of the symptoms, the patient was treated by the Thais onlay gastric patch method. The leakage happened after the surgery and he received a conservative treatment. After discharge no abnormalities, such as leakage and stricture, were found on the eso-phagogram The two patients now live a normal life.

• Journal of Chest Surgery
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• v.48 no.4
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• pp.298-301
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• 2015

Hematemesis is a rare manifestation of a ruptured bronchial artery aneurysm (BAA) in the mediastinum. It is difficult to diagnose a ruptured BAA presenting as hematemesis, because it can be confused with other diseases, such as Boerhaave's syndrome, variceal disease, or a perforated ulcer. In this report, we describe a case of BAA resulting in hematemesis and mediastinal hemorrhage.