Spontaneous rupture of the oesophagus: Boerhaave's syndrome in 2008. Literature review and treatment algorithm.
| Autor: | de Schipper JP; Department of Surgery, St. Elisabeth Hospital, Hilvarenbeekseweg 60, Tilburg, The Netherlands., Pull ter Gunne AF, Oostvogel HJ, van Laarhoven CJ |
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| Jazyk: | angličtina |
| Zdroj: | Digestive surgery [Dig Surg] 2009; Vol. 26 (1), pp. 1-6. Date of Electronic Publication: 2009 Jan 15. |
| DOI: | 10.1159/000191283 |
| Abstrakt: | Objective: Boerhaave's syndrome is a spontaneous rupture of the oesophagus with a lack of diagnostic and treatment consistency in the literature. Therefore, we reviewed all published literature in order to design a treatment algorithm based on the literature. Study Design: A systematic literature review written in the English language since 1975. Results: We reviewed all known literature. Treatment of the Boerhaave syndrome was divided into three categories: conservative, endoscopic and surgical approach. The survival rate of all treatments was 75, 100 and 81%, respectively. Conclusion: Boerhaave's syndrome should be treated endoscopically when diagnosed within 48 h and when there are no signs of sepsis. However, when a patient is diagnosed within 48 h and has a septic profile, thoracotomy with hemifundoplication and pleural/mediastinal drainage should be performed; and in case of intra-abdominal leakage, a laparotomy for local repair should be performed. When a patient is diagnosed after 48 h, conservative treatment should be followed and only when a patient gets a septic profile is surgical treatment indicated. (Copyright (c) 2009 S. Karger AG, Basel.) |
| Databáze: | MEDLINE |
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