Ramhamadany Eamon, Mohamed Saif, Jaunoo Shameen, Baker T, Mannath Jayan, Harding James, Menon Vinod
University Hospital Coventry and Warwickshire NHS Trust, Coventry, UK
University Hospital Coventry and Warwickshire NHS Trust, Coventry, UK.
J Surg Case Rep. 2013 May 2;2013(5):rjt020. doi: 10.1093/jscr/rjt020.
Boerhaave syndrome is a spontaneous perforation of the oesophagus secondary to forceful emesis. Surgery has been advocated in delayed presentations of Boerhaave's syndrome with mediastinitis. The over-the-scope clip (OTSC) by OVESCO(®) (Tubingen, Germany) has been used in the endoscopic management of gastrointestinal bleeds, fistulae and anastamotic leaks. We describe the successful endoscopic use of the OTSC in a delayed presentation of Boerhaave syndrome with mediastinitis. A 69-year-old gentleman underwent a computerised tomography scan, which demonstrated a lower oesophageal perforation and mediastinitis 7 days after admission, having presented with forceful emesis and chest discomfort. During endoscopy the defect was visualized and successfully closed using the OTSC. This resulted in a favourable outcome and is a technique not previously described in the literature to manage this condition.
博雷尔哈夫综合征是一种继发于剧烈呕吐的食管自发性穿孔。对于出现纵隔炎的延迟性博雷尔哈夫综合征，一直主张进行手术治疗。德国图宾根的OVESCO公司生产的内镜下套扎夹（OTSC）已用于胃肠道出血、瘘管和吻合口漏的内镜治疗。我们描述了OTSC在内镜下成功治疗一例出现纵隔炎的延迟性博雷尔哈夫综合征的病例。一名69岁男性患者因剧烈呕吐和胸部不适入院，入院7天后进行了计算机断层扫描，显示食管下段穿孔和纵隔炎。在内镜检查中，发现了缺损并使用OTSC成功封闭。这带来了良好的结果，且该技术在之前的文献中未曾描述用于治疗这种情况。
