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EnglishAIM: Report case of a 66-year-old man come to our observation for a bilateral pleural effusion, ten days after clinical manifestations of chest pain, initially misdiagnosed with a myocardial infarction. MATERIAL OF STUDY: On the same day, the patient underwent an emergency chest CT scan with orally administered contrast medium that confirmed our suspicion of breakage of the esophageal wall. The patient underwent to a left thoracotomy: the visceral pleura and all the structures covered by the parietal pleura were affected by a widespread necrotic process. The subsequent cleansing of the pleural cavity revealed that the distal portion of the thoracic esophagus was lacerated for about 5 cm; the tear was repaired with continuous reabsorbable sutures; to protect the suture fundoplication of the gastric fundus was performed. RESULTS: Post-operative course was complicated on 15th day by a chylous spreading from the chest drains; to complete the postoperative checks, a chest CT scan was therefore performed, orally administering the contrast medium without any signs of extraluminal spreading; the chylous effusion resolved spontaneously with diet. After being discharged, the patient was followed on an outpatient basis for 36 months. CONCLUSION: Boerhaave's syndrome is a rare and serious clinical condition; when a patient is diagnosed after 24-48 hs, many surgeons follow conservative treatment; however primary repair can be safely accomplished regardless of the time interval between perforation and operation, like our singular experience demonstrated
| Titolo: | BOERHAAVE’S SYNDROME: LONG FREE INTERVAL BEFORE SUCCESFUL PRIMARY REPAIR. CASE REPORT | |
| Autore/i: | STELLA, FRANCO; DAVOLI, FABIO; BRANDOLINI, JURY; DOLCI, GIAMPIERO; BINI, ALESSANDRO | |
| Autore/i Unibo: | ||
| Anno: | 2009 | |
| Rivista: | ||
| Abstract: | AIM: Report case of a 66-year-old man come to our observation for a bilateral pleural effusion, ten days after clinical manifestations of chest pain, initially misdiagnosed with a myocardial infarction. MATERIAL OF STUDY: On the same day, the patient underwent an emergency chest CT scan with orally administered contrast medium that confirmed our suspicion of breakage of the esophageal wall. The patient underwent to a left thoracotomy: the visceral pleura and all the structures covered by the parietal pleura were affected by a widespread necrotic process. The subsequent cleansing of the pleural cavity revealed that the distal portion of the thoracic esophagus was lacerated for about 5 cm; the tear was repaired with continuous reabsorbable sutures; to protect the suture fundoplication of the gastric fundus was performed. RESULTS: Post-operative course was complicated on 15th day by a chylous spreading from the chest drains; to complete the postoperative checks, a chest CT scan was therefore performed, orally administering the contrast medium without any signs of extraluminal spreading; the chylous effusion resolved spontaneously with diet. After being discharged, the patient was followed on an outpatient basis for 36 months. CONCLUSION: Boerhaave's syndrome is a rare and serious clinical condition; when a patient is diagnosed after 24-48 hs, many surgeons follow conservative treatment; however primary repair can be safely accomplished regardless of the time interval between perforation and operation, like our singular experience demonstrated | |
| Data prodotto definitivo in UGOV: | 2013-06-29 14:53:09 | |
| Appare nelle tipologie: | 1.01 Articolo in rivista |
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