迟发性Boerhaave综合征。阿根廷单中心经验：病例系列
Boerhaave's syndrome with late presentation. Experience in an Argentine single center: Case series.
作者信息
Velasco Hernández Daniel N, Horiuchi Héctor R, Rivaletto Lucas A, Farina Fidelio, Viscuso Matías
机构信息
University Hospital General San Martín, La Plata, Buenos Aires, Argentina.
出版信息
Ann Med Surg (Lond). 2019 Jul 13;45:59-61. doi: 10.1016/j.amsu.2019.07.023. eCollection 2019 Sep.
BACKGROUND
In the year 1724, Hermann Boerhaave reported a case of a Dutch admiral who died due to spontaneous rupture of the esophagus following vomiting. The aim of this retrospective study is to analyze the therapeutic modality, morbidity and mortaliy of a group of patients with spontaneous esophageal rupture treated in our hospital.
METHODS
Ten patients were treated from March 1990 to August 2016. Seven patients were males and three were females. The age range was, 52-72 years, with an average of 66.2 years. In four patients, the diagnosis and posterior treatment were performed within 24 h (Group I) and the remaining six patients after 24 h (Group II).
RESULTS
The mean hospital stay was 36.6 days (range 17-62 days). The mortality rate was 50%, which was due to septic shock and the morbidity of patients who survived was 40% due to pneumonia in one case and fistula in another.
DISCUSSIONS
This condition has a high mortality rate with a lethality that depends on the time between recognition of symptoms and proper surgical treatment.
背景
1724年，赫尔曼·布尔哈夫报告了一例荷兰海军上将的病例，该上将因呕吐后食管自发性破裂而死亡。本回顾性研究的目的是分析我院收治的一组自发性食管破裂患者的治疗方式、发病率和死亡率。
方法
1990年3月至2016年8月共治疗10例患者。男性7例，女性3例。年龄范围为52 - 72岁，平均66.2岁。4例患者在24小时内完成诊断及后续治疗（第一组），其余6例患者在24小时后进行治疗（第二组）。
结果
平均住院时间为36.6天（范围17 - 62天）。死亡率为50%，死因是感染性休克，存活患者的发病率为40%，其中1例因肺炎，另1例因瘘管。
讨论
这种疾病死亡率很高，其致死率取决于症状识别与恰当手术治疗之间的时间间隔。
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