Arconada J A, Hebrero J, Yangüela J, Milazzo A, Simón M A, Cabello J, García Portero F, Escudero B
Rev Esp Enferm Apar Dig. 1989 Jun;75(6 Pt 1):545-52.
We present 7 personal cases of Boerhaave syndrome, 6 treated surgically and one managed with conservative measures. Boerhaave's syndrome is one of the most serious gastro-intestinal perforation pictures. Although its frequency is scant, because of its seriousness it is important to be aware of it for early diagnosis. While a prompt diagnosis is important in any pathology, it is even more so in this syndrome since there is a clear relationship between the time lapse from perforation to the onset of treatment and the rate of survival. Although we present one case cured medically, this is exceptional and treatment is eminently surgical and should be as early as possible. The technique that provides the best results and an excellent morbimortality rate in relation to efficacy is primary suture followed by a fundal patch. In delayed cases with patients in deteriorated condition, other techniques can be considered. Due to its initial severity and a tendency to postoperative complications, the patient should be closely controlled, and correct antibiotic therapy and complete parenteral support nutrition are very important in treatment.
我们呈现7例Boerhaave综合征的个人病例，其中6例接受了手术治疗，1例采取保守治疗措施。Boerhaave综合征是最严重的胃肠道穿孔病症之一。尽管其发病率较低，但因其严重性，了解该病症以实现早期诊断十分重要。在任何疾病中，及时诊断都很重要，而在该综合征中更是如此，因为从穿孔到开始治疗的时间间隔与生存率之间存在明确关系。虽然我们展示了1例通过药物治愈的病例，但这是例外情况，治疗主要是手术治疗，且应尽早进行。与疗效相关的能提供最佳结果和出色病死率的技术是一期缝合，随后进行胃底补片修补。对于病情恶化的延迟病例，可考虑其他技术。由于其初始严重性及术后并发症的倾向，患者应受到密切监测，正确的抗生素治疗和完全胃肠外营养支持在治疗中非常重要。
