Boerhaave Syndrome in an Elderly Man

Pinto, Maria João Rodrigues Ferreira and Rodrigues, Pedro and Almeida, Leonor and Leitão, Alexandra and Flores, Luís and Gomes, André and Rocha, Gonçalo and Friões, Fernando (2018) Boerhaave Syndrome in an Elderly Man. European Journal of Case Reports in Internal Medicine, 5 (10). ISSN 2284-2594

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Boerhaave syndrome is rare, has an non-specific clinical presentation and most commonly develops after persistent vomiting. Septic shock dominates the clinical picture as a result of extensive infection of the mediastinum and pleural and abdominal cavities. The current management of Boerhaave syndrome includes conservative, endoscopic and surgical treatments. The authors present the case of a 94-year-old man admitted to hospital with community-acquired pneumonia with mild respiratory insufficiency complicated by oesophageal perforation after an episode of vomiting and the development of a large left pleural effusion. An endoscopic approach with the placement of an oesophageal prosthesis was chosen given the advanced age of the patient. The hospital stay was complicated by pleural effusion infection requiring broad-spectrum antibiotics and prosthesis substitution. The patient was discharged after 60 days of hospitalization, without the need for oxygen supplementation, and scoring 80% on the Karnofsky Performance Status Scale. The increase in average life expectancy requires a case-by-case approach, where the benefits of invasive manoeuvres and likelihood of discharge are weighed against an acceptable quality of life, aiming to prevent futile medical treatment.

Item Type: Article
Uncontrolled Keywords: Oesophageal perforation, Boerhaave syndrome, pneumothorax, pleural effusion
Subjects: 600 Tecnologia - Scienze applicate > 610 Medicina e salute (Classificare qui la tecnologia dei servizi medici) > 616 Malattie (classificare qui la Clinica medica, la medicina basata sull'evidenza, la Medicina interna, la Medicina sperimentale)
Depositing User: Greta Di Blasio
Date Deposited: 11 Jun 2019 10:47
Last Modified: 11 Jun 2019 10:47

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