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Boerhaave综合征的腹腔镜治疗:一例伴有术中视频的病例报告

Laparoscopic Management of Boerhaave's syndrome: a case report with an intraoperative video.

作者信息

Aref Hager, Yunus Tahir, Alhallaq Obadah

机构信息

Department of Surgery, International Medical Center, P.O. Box 2172, Jeddah, 21451, Saudi Arabia.

出版信息

BMC Surg. 2019 Aug 13;19(1):109. doi: 10.1186/s12893-019-0576-7.

Abstract

BACKGROUND

Boerhaave's syndrome involves a sudden elevation in the intraluminal pressure of the esophagus, causing a transmural perforation. It is associated with high morbidity and mortality. Its treatment is challenging, and early surgical intervention is the most crucial prognostic element.

CASE PRESENTATION

We present a case of a 32 year-old male who presented after severe emesis with an acute onset of epigastric pain. He was diagnosed with Boerhaave's syndrome. Displaying signs of shock mandated immediate surgical exploration with laparoscopic primary repair.

CONCLUSION

The golden period of the first 24 hrs of the event still applies to cases of esophageal perforation. The scarcity of these cases makes a comparison between the various treatment methods difficult. Our data support the use of laparoscopic intervention with primary repair as the mainstay of treatment for the management of esophageal perforation.

摘要

背景

博赫哈夫综合征涉及食管腔内压力突然升高,导致全层穿孔。它与高发病率和死亡率相关。其治疗具有挑战性,早期手术干预是最重要的预后因素。

病例报告

我们报告一例32岁男性病例,该患者在剧烈呕吐后出现急性上腹部疼痛。他被诊断为博赫哈夫综合征。出现休克体征要求立即进行腹腔镜一期修复手术探查。

结论

事件发生后的最初24小时这一黄金时期仍适用于食管穿孔病例。此类病例数量稀少,使得比较各种治疗方法变得困难。我们的数据支持将腹腔镜一期修复干预作为食管穿孔治疗的主要方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6bdf/6693239/2a9e403c7cff/12893_2019_576_Fig1_HTML.jpg

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