Pei Baoxiang, Gu Wenlong, Guan Qingmin, Kong Biao
Department of Thoracic Surgery, Jining First People's Hospital, No. 6 Jiankang Road, Jining 272011, Shandong Province, China.
Department of Thoracic Surgery, Qufu People's Hospital, No. 1 Guiren Street, Qufu, Jining City, Shandong Province, 272011, China.
J Surg Case Rep. 2025 Jun 9;2025(6):rjaf406. doi: 10.1093/jscr/rjaf406. eCollection 2025 Jun.
Introduction and importance: Spontaneous esophageal ruptures (SREs), also known as Boerhaave syndrome, are rare but potentially fatal medical emergencies characterized by full-layer perforation of the esophagus. Early identification and surgical intervention are critical for improving patient outcomes and reducing mortality rates. Case presentation: This study presents two case reports of patients with SREs who underwent surgical treatment. Both patients experienced lower esophageal segment perforations and were treated with emergency surgery for primary esophageal repair. One patient developed severe septic shock postoperatively and required intensive care and conservative treatment. Both patients recovered completely and had no late complications, such as esophageal strictures or feeding tube issues, at 6-month follow-up. Clinical discussion: This study reports surgical treatment experiences in two cases of SRE, a rare and fatal condition characterized by full-layer perforation of the esophagus. Early identification, diagnosis, and prompt surgical intervention are crucial for improving patient survival chances. The two cases involved lower esophageal segment perforation and underwent emergency surgery for primary esophageal repair. Healthcare providers should be vigilant for Boerhaave syndrome in patients presenting with acute chest and abdominal pain, particularly those with a history of vomiting. Thorough irrigation of the thoracic cavity during surgery is key to preventing septic shock postoperatively. Conclusion: Early diagnosis and prompt surgical intervention are essential for managing SREs. Thorough surgical debridement and drainage are key to preventing postoperative complications and improving survival rates.
自发性食管破裂（SREs），也称为博赫哈夫综合征，是一种罕见但可能致命的医疗急症，其特征为食管全层穿孔。早期识别和手术干预对于改善患者预后和降低死亡率至关重要。病例报告：本研究呈现了两例接受手术治疗的SRE患者的病例报告。两名患者均发生食管下段穿孔，并接受了急诊手术进行一期食管修复。一名患者术后发生严重感染性休克，需要重症监护和保守治疗。两名患者均完全康复，在6个月的随访中均无晚期并发症，如食管狭窄或喂养管问题。临床讨论：本研究报告了两例SRE的手术治疗经验，SRE是一种以食管全层穿孔为特征的罕见致命疾病。早期识别、诊断和及时的手术干预对于提高患者的生存几率至关重要。这两例均涉及食管下段穿孔，并接受了急诊手术进行一期食管修复。医疗服务提供者应对出现急性胸痛和腹痛的患者，尤其是有呕吐病史的患者警惕博赫哈夫综合征。手术期间对胸腔进行彻底冲洗是预防术后感染性休克的关键。结论：早期诊断和及时的手术干预对于处理SREs至关重要。彻底的手术清创和引流是预防术后并发症和提高生存率的关键。
