Journal of Minimal Access Surgery
Vol. 6, No. 3, 2010, pp. 76-79
Bioline Code: ma10021
Full paper language: English
Document type: Case Report
Document available free of charge
Journal of Minimal Access Surgery, Vol. 6, No. 3, 2010, pp. 76-79
© Copyright 2010 Journal of Minimal Access Surgery.
Boerhaave's syndrome: Thoracolaparoscopic approach|
Vaidya, Shulmit; Prabhudessai, Suraj; Jhawar, Nitish & Patankar, Roy V.
We present a case of Boerhaave′s syndrome managed thoracolaparoscopically. A 45-year- old man presented with hydropneumothorax following severe retching. He was treated with Intercostal drainage insertion as the primary management and referred to a tertiary care centre. There endoscopic stapling was attempted, following which he developed a leak. He presented to us with severe sepsis and mediastinal collection on the ninth day following the perforation. We treated him with thoracoscopic mediastinal toilet, laparoscopic-assisted feeding jejunostomy and cervical oesophagostomy. The patient was managed conservatively. A computed tomography (CT) scan was repeated at intervals of 15 days. He was continued on full jejunostomy feeds. Regular assessment of the oesophagus injury was conducted via the CT scan. The patient had complete healing of the perforation at end of two months. His oesophagostomy was closed and he remained symptom-free at follow-up. We conclude that thoracoscopy has an important role to play in the management of patients with mediastinal sepsis and late presentation of Boerhaave′s perforation.
Boerhaave′s, thoracoscopy, feeding jejunostomy, laparoscopy, oesophagostomy
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