[Boerhaave's syndrome and pleural tuberculosis]

Rev Mal Respir. 2011 Jan;28(1):75-9. doi: 10.1016/j.rmr.2010.05.017. Epub 2011 Jan 11.
[Article in French]

Abstract

Introduction: Boerhaave's syndrome is a rare condition involving spontaneous rupture of the oesophagus. The diagnosis is difficult and the prognosis depends on early diagnosis and treatment.

Case report: We report a case of spontaneous rupture of the oesophagus in a 70-year-old woman where the diagnosis was delayed. Initial treatment comprised dual antibiotic therapy and feeding via a jejunostomy. Three months later, direct suture of the oesophagus was performed successfully. A routine pleural biopsy performed during the surgery revealed pleural tuberculosis. Antituberculous treatment was given for 6 months with good progress after 16 months follow up.

Conclusion: Boerhaave's syndrome is a rare condition, the diagnosis of which remains difficult. The prognosis is related essentially to the speed of diagnosis. The treatment is always surgical within the framework of appropriate medical management (intensive care, antibiotic therapy). There should be a systematic search for associated pathology.

Publication types

  • Case Reports
  • English Abstract

MeSH terms

  • Aged
  • Anti-Bacterial Agents / therapeutic use
  • Antitubercular Agents / therapeutic use
  • Biopsy
  • Combined Modality Therapy
  • Delayed Diagnosis
  • Diagnosis, Differential
  • Empyema, Pleural / etiology*
  • Empyema, Pleural / pathology
  • Empyema, Pleural / therapy
  • Esophageal Perforation / diagnosis
  • Esophageal Perforation / pathology
  • Esophageal Perforation / therapy
  • Female
  • Humans
  • Klebsiella Infections / etiology*
  • Klebsiella Infections / pathology
  • Klebsiella Infections / therapy
  • Mediastinal Diseases / diagnosis
  • Mediastinal Diseases / pathology
  • Mediastinal Diseases / therapy
  • Mediastinal Emphysema / etiology*
  • Mediastinal Emphysema / pathology
  • Mediastinal Emphysema / therapy
  • Pleura / pathology
  • Recurrence
  • Rupture, Spontaneous
  • Thoracotomy
  • Tuberculosis, Pleural / complications*
  • Tuberculosis, Pleural / diagnosis*
  • Tuberculosis, Pleural / pathology
  • Tuberculosis, Pleural / therapy

Substances

  • Anti-Bacterial Agents
  • Antitubercular Agents

Supplementary concepts

  • Boerhaave syndrome