Despite of the important progress in thoracic surgery, the treatment of esophageal perforation remain a discussed and controversial argument. A woman of 83 years old, was admitted to hospital for epigastric pain arised since 24 hours with nausea, emesis and fever. Initially the case was suggesting for a cholecistitis; after four days we assisted to an aggravation of symptomathology associated with cervical emphisema. The thoracic CT response was "a mediastinitis due to a rupture of the esophagus". Medical treatment was total parenteral nutrition and best performed antibiotic therapy. The patient had a slow improvement until complete recovery. At the beginning, symptomathology was prevalently abdominal (biliary colic and emesis); for this reason, diagnosis was done when mediastinitis was already established and surgical treatment was very dangerous. In conclusion the Boerhaave's Syndrome is a rare pathology and it can starts with an unclear symptomathology. When diagnosis is late, surgical treatment is extremely dangerous and sometimes, we may obtained good results with conservative therapy.

Testi, W., Voltolini, L., Malatesti, R., Silverio, R., Macchitella, Y., DE MARTINO, A., et al. (2006). Conservative treatment of Boerhaave's syndrome in the elderly: Case report [Trattamento conservativo della sindrome di Boerhaave nell'anziano]. CHIRURGIA, 19(4), 279-283.

Conservative treatment of Boerhaave's syndrome in the elderly: Case report [Trattamento conservativo della sindrome di Boerhaave nell'anziano]

TESTI W.;BOTTA G.;
2006-01-01

Abstract

Despite of the important progress in thoracic surgery, the treatment of esophageal perforation remain a discussed and controversial argument. A woman of 83 years old, was admitted to hospital for epigastric pain arised since 24 hours with nausea, emesis and fever. Initially the case was suggesting for a cholecistitis; after four days we assisted to an aggravation of symptomathology associated with cervical emphisema. The thoracic CT response was "a mediastinitis due to a rupture of the esophagus". Medical treatment was total parenteral nutrition and best performed antibiotic therapy. The patient had a slow improvement until complete recovery. At the beginning, symptomathology was prevalently abdominal (biliary colic and emesis); for this reason, diagnosis was done when mediastinitis was already established and surgical treatment was very dangerous. In conclusion the Boerhaave's Syndrome is a rare pathology and it can starts with an unclear symptomathology. When diagnosis is late, surgical treatment is extremely dangerous and sometimes, we may obtained good results with conservative therapy.
2006
Testi, W., Voltolini, L., Malatesti, R., Silverio, R., Macchitella, Y., DE MARTINO, A., et al. (2006). Conservative treatment of Boerhaave's syndrome in the elderly: Case report [Trattamento conservativo della sindrome di Boerhaave nell'anziano]. CHIRURGIA, 19(4), 279-283.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11365/9326
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