CASE REPORT |
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Year : 2018 | Volume
: 31
| Issue : 4 | Page : 1476-1478 |
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Boerhaave syndrome: A dilemma for the private practitioner (a case report)
Ezekiel O Ogunleye1, Oyebola O Adekola2, Augustine J Olugbemi2, Olugbenga O Ojo2, Saheed B Sanni2
1 Department of Surgery, Cardiothoracic Surgery Unit, College of Medicine, Lagos University Teaching Hospital, University of Lagos, Surulere, Lagos, Nigeria 2 Department of Anaesthesia, College of Medicine, Lagos University Teaching Hospital, University of Lagos, Surulere, Lagos, Nigeria
Correspondence Address:
Ezekiel O Ogunleye Department of Surgery, Cardiothoracic Surgery Unit, College of Medicine, Lagos University Teaching Hospital, University of Lagos, Surulere P.M.B12003, Lagos Nigeria
Source of Support: None, Conflict of Interest: None | Check |
DOI: 10.4103/mmj.mmj_365_17
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Spontaneous esophageal rupture (Boerhaave syndrome) is a rare condition, and many physicians may be unfamiliar with its presentation. A delay in diagnosis and intervention leads to increased morbidity and mortality. We report on a 43-year-old man referred to our facility with a 9-day history of worsening chest pain, respiratory distress, and fever after bouts of retching and vomiting following binge drinking at a party. He presented 8 days earlier at a private hospital, where he underwent a left-sided thoracostomy for empyema thoracis. A computerized tomography of the chest and abdomen was ordered. It indicated a left-sided hydropneumothorax with a collapsed ipsilateral lower lobe, and contrast extravasation into the left pleural space at the distal one-third of the esophagus anterior to the descending thoracic aorta. The diagnosis of Boerhaave syndrome with mediastinitis was confirmed. He was transferred to the ICU and subsequently underwent a left posterior lateral thoracotomy, with esophageal resection performed. Seven days postoperatively, he developed an esophageal leakage, which required an esophageal stent.
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