Ceriz Tiago, Diegues Andreia, Lagarteira João, Terras Alexandre Rui, Carrascal Andrés
Internal Medicine Department, Unidade Local de Saúde do Nordeste, Bragança, PRT.
Intensive Medicine and Emergency Department, Unidade Local de Saúde do Nordeste, Bragança, PRT.
Cureus. 2022 Apr 5;14(4):e23836. doi: 10.7759/cureus.23836. eCollection 2022 Apr.
Boerhaave's syndrome is a rare spontaneous perforation of the esophagus with high mortality. The diagnosis is difficult because it has no specific symptom. It requires urgent intervention. We report the case of a 63-year-old male admitted to the emergency department with respiratory distress. Chest computed tomography (CT) revealed large, bilateral, and tension hydropneumothorax, stomach distention, and aerobilia. Thoracic drainage was performed immediately. Control CT revealed esophagus perforation in the middle third of the esophagus with extravasation of the contrast product from the esophagus to the pleura. Urgent surgery was performed, and the patient was admitted to the intensive care unit (ICU) with septic shock. Early diagnosis and management with a damage control approach including thoracic drainage and surgery are essential to improve prognosis and reduce mortality.
博赫哈夫综合征是一种罕见的食管自发性穿孔，死亡率很高。由于没有特异性症状，诊断困难。它需要紧急干预。我们报告一例63岁男性因呼吸窘迫入住急诊科的病例。胸部计算机断层扫描（CT）显示双侧大量张力性气胸、胃扩张和气腹。立即进行了胸腔引流。对照CT显示食管中三分之一处穿孔，造影剂从食管渗入胸膜。进行了紧急手术，患者因感染性休克入住重症监护病房（ICU）。采用包括胸腔引流和手术在内的损伤控制方法进行早期诊断和治疗对于改善预后和降低死亡率至关重要。
