Barogenic rupture of the esophagus (Boerhaave's syndrome): successful treatment of a late case.

This article presents a case of barogenic (postemetic) rupture of the esophagus that was diagnosed more than 48 hours after the acute event and subsequently treated successfully. The initial approach of direct esophageal repair, pleural drainage, antibiotics, and intravenous hyperalimentation was not successful. The repair site disrupted, and the patient became critically ill and septic. Salvage of the patient with closure of the fistula and normal alimentation was accomplished by partial distal esophageal occlusion, utilizing a serrated (Miles) vena cava clip.