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Suitable Diagnosis and Treatment of Esophageal Ruptures in Cases of Non-Boerhaave Syndrome: A Comparison With Boerhaave Syndrome
- Source :
- Journal of Investigative Medicine High Impact Case Reports, Journal of Investigative Medicine High Impact Case Reports, Vol 9 (2021)
- Publication Year :
- 2021
- Publisher :
- SAGE Publications, 2021.
-
Abstract
- Boerhaave syndrome (BS) is frequently reported in cases of esophageal perforation; however, there are relatively few studies on non–Boerhaave syndrome (nBS). This study clarifies the appropriate diagnosis and treatment for patients with nBS among those with esophageal ruptures. Twelve patients with esophageal ruptures who underwent surgery at our department over 14 years were classified into 2 groups: 4 in the nBS group and 8 in the BS group. Patient characteristics, surgical methods, surgical outcomes, and complications were compared between the groups. The chief complaints varied between the groups. The nBS group had significantly higher preoperative C-reactive protein ( P = .007) and required 5 days (median) from onset to surgery. Moreover, the perforation diameter was significantly smaller in the nBS group than in the BS group ( P = .013). Suturing of the perforation site was performed during the initial surgery in 8 BS group patients (100%) and 1 nBS group patient (25%; P = .018). Only drainage was performed during the initial surgery for 3 nBS group patients (75%). The complications did not significantly differ between the groups ( P = 1.000), and no deaths were reported. The chief complaints of patients with nBS are diverse, and esophageal perforation should be cited as a differential diagnosis even in the absence of vomiting or chest pain symptoms. In the initial surgery for patients with nBS, the perforation site does not necessarily need to be closed. It is treatable by second-stage surgery or by natural closing.
- Subjects :
- mediastinal abscess
Medicine (General)
medicine.medical_specialty
Boerhaave syndrome
Epidemiology
diagnosis
Perforation (oil well)
Patient characteristics
Case Report
Chest pain
Surgical methods
Diagnosis, Differential
R5-920
Pathology
medicine
Mediastinal Diseases
RB1-214
Humans
Safety, Risk, Reliability and Quality
Esophageal Perforation
business.industry
food and beverages
medicine.disease
Surgery
Mediastinal abscess
embryonic structures
Vomiting
medicine.symptom
Differential diagnosis
business
Tomography, X-Ray Computed
Safety Research
drainage
Subjects
Details
- Language :
- English
- ISSN :
- 23247096
- Volume :
- 9
- Database :
- OpenAIRE
- Journal :
- Journal of Investigative Medicine High Impact Case Reports
- Accession number :
- edsair.doi.dedup.....c1c4c1f74f931e05f09bf7b5b79f2621