Wednesday, October 3, 2018

Boerhaave's syndrome : Dr Keyur Bhatt

Boerhaave's syndrome

An Elderly male with a history of pain in a left chest for 2 hours, on investigations, found to have gross left hydropneumothorax ICD
Kept and a patient was conservative.

Day 3 - CT Chest was done s/o empyema left chest thoracoscopy and lavage was given patient continued to have 1000ml/day ICD output Repeat chest CECT with oral contrast done on DAY 7 which s/o gross leak of contrast from lower one-third of an esophagus in the left thoracic cavity.

Transferred to SIDS Hospital & Research Center OGD Scope was done with CO2
s/o: Lower end left sided 3 cm esophageal perforation.

PLAN : Laparoscopy and repair of perforation feeding jejunostomy Thorascopy / Mini thoracotomy and lavage.

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