Suitable Diagnosis and Treatment of Esophageal Ruptures in Cases of Non-Boerhaave Syndrome: A Comparison With Boerhaave Syndrome
Boerhaave syndrome (BS) is frequently reported in cases of esophageal perforation; however, there are relatively few studies on non–Boerhaave syndrome (nBS). This study clarifies the appropriate diagnosis and treatment for patients with nBS among those with esophageal ruptures. Twelve patients with...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2021-05-01
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| Series: | Journal of Investigative Medicine High Impact Case Reports |
| Online Access: | https://doi.org/10.1177/23247096211014683 |
| _version_ | 1818454123793612800 |
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| author | Shunsuke Hayakawa MD Ryo Ogawa MD, PhD Sunao Ito MD Seiichi Nakaya MD Tomotaka Okubo MD, PhD Hiroyuki Sagawa MD, PhD Tatsuya Tanaka MD, PhD Hiroki Takahashi MD, PhD Yoichi Matsuo MD, PhD Shuji Takiguchi MD, PhD |
| author_facet | Shunsuke Hayakawa MD Ryo Ogawa MD, PhD Sunao Ito MD Seiichi Nakaya MD Tomotaka Okubo MD, PhD Hiroyuki Sagawa MD, PhD Tatsuya Tanaka MD, PhD Hiroki Takahashi MD, PhD Yoichi Matsuo MD, PhD Shuji Takiguchi MD, PhD |
| author_sort | Shunsuke Hayakawa MD |
| collection | DOAJ |
| description | Boerhaave syndrome (BS) is frequently reported in cases of esophageal perforation; however, there are relatively few studies on non–Boerhaave syndrome (nBS). This study clarifies the appropriate diagnosis and treatment for patients with nBS among those with esophageal ruptures. Twelve patients with esophageal ruptures who underwent surgery at our department over 14 years were classified into 2 groups: 4 in the nBS group and 8 in the BS group. Patient characteristics, surgical methods, surgical outcomes, and complications were compared between the groups. The chief complaints varied between the groups. The nBS group had significantly higher preoperative C-reactive protein ( P = .007) and required 5 days (median) from onset to surgery. Moreover, the perforation diameter was significantly smaller in the nBS group than in the BS group ( P = .013). Suturing of the perforation site was performed during the initial surgery in 8 BS group patients (100%) and 1 nBS group patient (25%; P = .018). Only drainage was performed during the initial surgery for 3 nBS group patients (75%). The complications did not significantly differ between the groups ( P = 1.000), and no deaths were reported. The chief complaints of patients with nBS are diverse, and esophageal perforation should be cited as a differential diagnosis even in the absence of vomiting or chest pain symptoms. In the initial surgery for patients with nBS, the perforation site does not necessarily need to be closed. It is treatable by second-stage surgery or by natural closing. |
| first_indexed | 2024-12-14T21:49:53Z |
| format | Article |
| id | doaj.art-1f496bf0bcbc4b7f8889c1f0bf22e5d8 |
| institution | Directory Open Access Journal |
| issn | 2324-7096 |
| language | English |
| last_indexed | 2024-12-14T21:49:53Z |
| publishDate | 2021-05-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Journal of Investigative Medicine High Impact Case Reports |
| spelling | doaj.art-1f496bf0bcbc4b7f8889c1f0bf22e5d82022-12-21T22:46:16ZengSAGE PublishingJournal of Investigative Medicine High Impact Case Reports2324-70962021-05-01910.1177/23247096211014683Suitable Diagnosis and Treatment of Esophageal Ruptures in Cases of Non-Boerhaave Syndrome: A Comparison With Boerhaave SyndromeShunsuke Hayakawa MD0Ryo Ogawa MD, PhD1Sunao Ito MD2Seiichi Nakaya MD3Tomotaka Okubo MD, PhD4Hiroyuki Sagawa MD, PhD5Tatsuya Tanaka MD, PhD6Hiroki Takahashi MD, PhD7Yoichi Matsuo MD, PhD8Shuji Takiguchi MD, PhD9Nagoya City University, Nagoya City, JapanNagoya City University, Nagoya City, JapanNagoya City University, Nagoya City, JapanNagoya City University, Nagoya City, JapanNagoya City University, Nagoya City, JapanNagoya City University, Nagoya City, JapanNagoya City University, Nagoya City, JapanNagoya City University, Nagoya City, JapanNagoya City University, Nagoya City, JapanNagoya City University, Nagoya City, JapanBoerhaave syndrome (BS) is frequently reported in cases of esophageal perforation; however, there are relatively few studies on non–Boerhaave syndrome (nBS). This study clarifies the appropriate diagnosis and treatment for patients with nBS among those with esophageal ruptures. Twelve patients with esophageal ruptures who underwent surgery at our department over 14 years were classified into 2 groups: 4 in the nBS group and 8 in the BS group. Patient characteristics, surgical methods, surgical outcomes, and complications were compared between the groups. The chief complaints varied between the groups. The nBS group had significantly higher preoperative C-reactive protein ( P = .007) and required 5 days (median) from onset to surgery. Moreover, the perforation diameter was significantly smaller in the nBS group than in the BS group ( P = .013). Suturing of the perforation site was performed during the initial surgery in 8 BS group patients (100%) and 1 nBS group patient (25%; P = .018). Only drainage was performed during the initial surgery for 3 nBS group patients (75%). The complications did not significantly differ between the groups ( P = 1.000), and no deaths were reported. The chief complaints of patients with nBS are diverse, and esophageal perforation should be cited as a differential diagnosis even in the absence of vomiting or chest pain symptoms. In the initial surgery for patients with nBS, the perforation site does not necessarily need to be closed. It is treatable by second-stage surgery or by natural closing.https://doi.org/10.1177/23247096211014683 |
| spellingShingle | Shunsuke Hayakawa MD Ryo Ogawa MD, PhD Sunao Ito MD Seiichi Nakaya MD Tomotaka Okubo MD, PhD Hiroyuki Sagawa MD, PhD Tatsuya Tanaka MD, PhD Hiroki Takahashi MD, PhD Yoichi Matsuo MD, PhD Shuji Takiguchi MD, PhD Suitable Diagnosis and Treatment of Esophageal Ruptures in Cases of Non-Boerhaave Syndrome: A Comparison With Boerhaave Syndrome Journal of Investigative Medicine High Impact Case Reports |
| title | Suitable Diagnosis and Treatment of Esophageal Ruptures in Cases of Non-Boerhaave Syndrome: A Comparison With Boerhaave Syndrome |
| title_full | Suitable Diagnosis and Treatment of Esophageal Ruptures in Cases of Non-Boerhaave Syndrome: A Comparison With Boerhaave Syndrome |
| title_fullStr | Suitable Diagnosis and Treatment of Esophageal Ruptures in Cases of Non-Boerhaave Syndrome: A Comparison With Boerhaave Syndrome |
| title_full_unstemmed | Suitable Diagnosis and Treatment of Esophageal Ruptures in Cases of Non-Boerhaave Syndrome: A Comparison With Boerhaave Syndrome |
| title_short | Suitable Diagnosis and Treatment of Esophageal Ruptures in Cases of Non-Boerhaave Syndrome: A Comparison With Boerhaave Syndrome |
| title_sort | suitable diagnosis and treatment of esophageal ruptures in cases of non boerhaave syndrome a comparison with boerhaave syndrome |
| url | https://doi.org/10.1177/23247096211014683 |
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