Zenone E A, Trotman B W
JAMA. 1977 Nov 7;238(19):2048-9. doi: 10.1001/jama.238.19.2048.
Although Boerhaave's syndrome is usually a surgical emergency, we recently observed a 57-year-old man with a chronic Boerhaave's syndrome. Initially, he responded to conservative management. However, the spontaneous formation of an esophageal-bronchial fistula complicated his course. Pulmonary symptoms and weight loss prompted surgical intervention. We speculate that the patient's six-week clinical course before surgery was tolerated because the contamination of the mediastinum following the initial esophageal tear was well contained and allowed sufficient time for the spontaneous formation of an esophageal-bronchial fistula.
虽然博雷尔哈夫综合征通常是一种外科急症，但我们最近观察到一名57岁患有慢性博雷尔哈夫综合征的男性。起初，他对保守治疗有反应。然而，食管支气管瘘的自发形成使他的病情复杂化。肺部症状和体重减轻促使进行手术干预。我们推测，患者在手术前六周的临床过程能够耐受，是因为最初食管撕裂后纵隔的污染得到了很好的控制，并有足够的时间让食管支气管瘘自发形成。
