Conservative treatment of Boerhaave’s syndrome in an octogenarian complicated with late distal esophageal stenosis and successfully treated by stent placement

Abstract

An 83-year-old female patient presented to the Emergency Department with shortness of breath, difficulty swallowing and leftsided chest pain following a vomiting attempt. A rupture in the left lower third of the esophagus, with hydropneumothorax, pneumomediastinum, and subcutaneous emphysema was revealed by chest X-ray, thoracic computed tomography scan, and contrast esophagography. The patient was successfully treated conservatively with closed thoracostomy, intravenous fluids, parenteral nutrition, and broad-spectrum antibiotics coverage. Following the successful conservative treatment, the patient developed a distal esophageal stenosis which was treated with an intra-esophageal self-expanding stent.

Keywords

• Esophagus. Spontaneous rupture. Esophageal rupture. Esophageal tear. Esophageal perforation. Boerhaave’s syndrome.