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一例成功治疗的患有Boerhaave综合征延迟诊断及严重并发症的患者病例

A Case of a Successfully Treated Patient With a Delayed Diagnosis of Boerhaave's Syndrome and Severe Complications.

作者信息

Yankov Georgi, Alexieva Magdalena, Makshutova Zaharinka, Vladimirov Borislav, Kovacheva-Slavova Mila

机构信息

Thoracic Surgery, University Hospital "St. Ivan Rilski", Sofia, BGR.

Gastroenterology, Institute for Specialization and Mastering of Doctors, University Hospital Tsaritsa Ioanna, Sofia, BGR.

出版信息

Cureus. 2024 Nov 19;16(11):e74018. doi: 10.7759/cureus.74018. eCollection 2024 Nov.

DOI:10.7759/cureus.74018
PMID:39703313
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11658894/
Abstract

Boerhaave's syndrome is a rare critical condition manifesting as transmural esophageal rupture. It is usually associated with forceful emesis and increased intraesophageal pressure. Immediate aggressive surgical intervention is imperative in such cases. We present a patient with a late diagnosis of Boerhaave's syndrome who was successfully treated in our department. We performed a subtotal esophageal resection, esophagostomy, gastrostomy, pyloroplasty by Heineke-Mikulicz, debridement, bilateral early decortication of the lung, and cleaning of the pleural cavities and mediastinum.

摘要

博雷哈夫综合征是一种罕见的危急病症，表现为食管全层破裂。它通常与剧烈呕吐和食管内压力升高有关。在这种情况下，立即进行积极的手术干预势在必行。我们报告了一名在我院成功治疗的博雷哈夫综合征晚期诊断患者。我们进行了食管次全切除术、食管造口术、胃造口术、海涅克-米库利茨幽门成形术、清创术、双侧早期肺剥脱术以及胸膜腔和纵隔清理术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4d63/11658894/180966d18ecc/cureus-0016-00000074018-i07.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4d63/11658894/f1bda7128b79/cureus-0016-00000074018-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4d63/11658894/01c2a22ddd1e/cureus-0016-00000074018-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4d63/11658894/1faedfd9737a/cureus-0016-00000074018-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4d63/11658894/80bfc099d660/cureus-0016-00000074018-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4d63/11658894/4896f2417583/cureus-0016-00000074018-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4d63/11658894/e9344fa45ee3/cureus-0016-00000074018-i06.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4d63/11658894/180966d18ecc/cureus-0016-00000074018-i07.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4d63/11658894/f1bda7128b79/cureus-0016-00000074018-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4d63/11658894/01c2a22ddd1e/cureus-0016-00000074018-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4d63/11658894/1faedfd9737a/cureus-0016-00000074018-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4d63/11658894/80bfc099d660/cureus-0016-00000074018-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4d63/11658894/4896f2417583/cureus-0016-00000074018-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4d63/11658894/e9344fa45ee3/cureus-0016-00000074018-i06.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4d63/11658894/180966d18ecc/cureus-0016-00000074018-i07.jpg

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本文引用的文献

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Endoscopic Management of Boerhaave Syndrome: Are Outcomes Better Than Surgery? A Case Report and Review of Literature.食管破裂综合征的内镜治疗：其疗效是否优于手术？病例报告及文献综述
J Community Hosp Intern Med Perspect. 2024 Mar 4;14(2):104-108. doi: 10.55729/2000-9666.1324. eCollection 2024.
2
Surgical treatment of Boerhaave syndrome in the past, present and future: updated results of a specialised surgical unit.Boerhaave 综合征的过去、现在和未来的外科治疗：专门外科单位的最新结果。
Ann R Coll Surg Engl. 2024 Jul;106(6):509-514. doi: 10.1308/rcsann.2024.0020. Epub 2024 Apr 2.
3
Two-staged surgical management for complicated Boerhaave syndrome with esophagectomy and deferred gastroplasty: A case report.
Int J Surg Case Rep. 2023 Feb;103:107881. doi: 10.1016/j.ijscr.2023.107881. Epub 2023 Jan 11.
4
Minimally invasive surgical management of Boerhaave's syndrome: a narrative literature review.Boerhaave综合征的微创外科治疗：文献综述
J Thorac Dis. 2020 Aug;12(8):4411-4417. doi: 10.21037/jtd-20-1020.
5
Challenges faced in the management of complicated Boerhaave syndrome: a tertiary care center experience.复杂型Boerhaave综合征管理中面临的挑战：一家三级医疗中心的经验
Pan Afr Med J. 2020 Jun 3;36:65. doi: 10.11604/pamj.2020.36.65.23666. eCollection 2020.
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Boerhaave's syndrome with late presentation. Experience in an Argentine single center: Case series.迟发性Boerhaave综合征。阿根廷单中心经验：病例系列
Ann Med Surg (Lond). 2019 Jul 13;45:59-61. doi: 10.1016/j.amsu.2019.07.023. eCollection 2019 Sep.
7
Transition of a Mallory-Weiss syndrome to a Boerhaave syndrome confirmed by anamnestic, necroscopic, and autopsy data: A case report.根据既往史、尸检及解剖数据确诊的马洛里-魏斯综合征转变为博雷尔哈夫综合征：一例报告
Medicine (Baltimore). 2018 Dec;97(49):e13191. doi: 10.1097/MD.0000000000013191.
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Tension hydropneumothorax as the initial presentation of Boerhaave syndrome.张力性液气胸作为博雷尔哈夫综合征的初始表现。
Respir Med Case Rep. 2018 Jul 31;25:100-103. doi: 10.1016/j.rmcr.2018.07.007. eCollection 2018.
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Biomed Res Int. 2018 Jun 28;2018:8483401. doi: 10.1155/2018/8483401. eCollection 2018.
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