Surgical treatment experiences in two cases of spontaneous esophageal ruptures

TL;DR

This paper reports successful surgical treatment of two rare cases of spontaneous esophageal ruptures, emphasizing the importance of early diagnosis and thorough surgical care.

Contribution

The paper contributes two case reports highlighting successful surgical management and outcomes of spontaneous esophageal ruptures.

Findings

Both patients with spontaneous esophageal ruptures recovered completely after emergency surgery.

Thorough thoracic cavity irrigation during surgery helped prevent postoperative septic shock.

No late complications like esophageal strictures were observed at 6-month follow-up.

Abstract

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.

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