Minimally invasive endoscopic therapy for the management of Boerhaave's syndrome
JH Darrien,H Kasem +1 more
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TLDR
Using a case series, it is demonstrated how minimally invasive endoscopic therapies can be used successfully to manage such a cohort of patients with Boerhaave’s syndrome.Abstract:
IntroductionBoerhaave’s syndrome represents the most lethal of all gastrointestinal perforations. In 2009 a treatment algorithm was published based on current level 4 evidence indicating that all septic patients should be treated surgically, early presentations without sepsis endoscopically and delayed presentations without sepsis conservatively. No provision was made for septic patients unfit for surgical intervention. Using a case series, we demonstrate how minimally invasive endoscopic therapies can be used successfully to manage such a cohort. MethodsBetween September 2008 and January 2010, five patients presented to Wishaw General Hospital with Boerhaave’s syndrome, all with an associated septic profile and none fit for surgery. They were managed using minimally invasive endoscopic therapies including endoscopic placement of oesophageal stents, elimination of mediastinal/pleural contamination using video assisted thorascopic lavage, management of subsequent collections using sinus tract endoscopy and...read more
Citations
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Journal ArticleDOI
Epidemiology, diagnosis, and management of esophageal perforations: systematic review.
TL;DR: As esophageal perforation represents a high-risk clinical condition without consensus regarding optimal management, there should be large multicenter prospective studies or Randomized Controlled Trial (RCT)s performed in order to advance diagnostic and therapeutic approach of such challenging pathology.
Journal ArticleDOI
Management and outcome of esophageal stenting for spontaneous esophageal perforations.
Torben Glatz,Goran Marjanovic,Birte Kulemann,Julian Hipp,Ulrich T. Hopt,Andreas Fischer,Hans-Jürgen Richter-Schrag,Jens Hoeppner +7 more
TL;DR: Endoscopic treatment of CSES treatment of spontaneous esophageal perforation is beneficial to the patient if immediately successful, but in the authors' experience, failure rates are higher than described in the literature.
Journal ArticleDOI
Minimally invasive surgical management of spontaneous esophageal perforation (Boerhaave’s syndrome)
TL;DR: Minimally invasive surgical management of spontaneous esophageal perforations with medium to high perforation severity scores is feasible and safe, with outcomes which compare favorably to the published literature.
Journal ArticleDOI
Role of Endoscopy in the Management of Boerhaave Syndrome.
Juan Ignacio Tellechea,Jean-Michel Gonzalez,Pablo Miranda-García,Adrian Culetto,Xavier Benoit D’Journo,Pascal Thomas,Marc Barthet +6 more
TL;DR: Endoscopy is an useful tool at all stages BS management: difficult diagnosis, primary treatment in selected patients and as salvage when surgery fails, with mortality rates and outcomes comparables to surgery.
Journal ArticleDOI
Non-surgical management of Boerhaave's syndrome: a case series study and review of the literature.
TL;DR: Endoscopic treatment seems to be an effective management strategy in patients with BS, and satisfactory results in patients presenting with sepsis are noted, presumably due to urgent, interventional radiology-guided fluid drainage.
References
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Journal ArticleDOI
Spontaneous rupture of the oesophagus: Boerhaave's syndrome in 2008. Literature review and treatment algorithm.
TL;DR: Boerhaave’s syndrome should be treated endoscopically when diagnosed within 48 h and when there are no signs of sepsis, but only when a patient gets a septic profile is surgical treatment indicated.
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Short-term esophageal stenting in the management of benign perforations
TL;DR: In patients with a benign esophageal perforation, temporary stent therapy is effective and provides a good alternative to surgery, and complications due to stent removal can be prevented by removal of the prosthesis within 6 weeks after insertion.
Journal ArticleDOI
Spontaneous rupture of the oesophagus
TL;DR: The aim of this study was to evaluate the diagnosis, management and outcome of patients with spontaneous rupture of the oesophagus in a single centre.