Conservative treatment of esophageal perforation related to a peptic ulcer with pyloric stenosis

We report a case of esophageal perforation (Boerhaave syndrome) caused by vomiting related to a duodenal ulcer with pyloric stenosis. A 45-year-old male presented with left chest pain and dyspnea after forceful vomiting. Chest radiography and computed tomography (CT) revealed a massive left pleural...

Full description

Saved in:
Bibliographic Details
Published in:Clinical journal of gastroenterology Vol. 7; no. 4; pp. 295 - 298
Main Authors: Tanaka, Ryo, Kosugi, Shin-ichi, Sato, Daisuke, Hirukawa, Hiroshi, Tada, Tetsuya, Ichikawa, Hiroshi, Hanyu, Takaaki, Ishikawa, Takashi, Kobayashi, Takashi, Wakai, Toshifumi
Format: Journal Article
Language:English
Published: Tokyo Springer Japan 01.08.2014
Subjects:
Abdominal Surgery
Case Report
Colorectal Surgery
Duodenal Ulcer - complications
Esophageal Perforation - etiology
Esophageal Perforation - therapy
Gastroenterology
Hepatology
Humans
Male
Mediastinal Diseases - etiology
Mediastinal Diseases - therapy
Medicine
Medicine & Public Health
Middle Aged
Pyloric Stenosis - complications
Remission Induction
Surgical Oncology
Pyloric stenosis
Esophageal perforation
Conservative treatment
ISSN:1865-7257, 1865-7265, 1865-7265
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:We report a case of esophageal perforation (Boerhaave syndrome) caused by vomiting related to a duodenal ulcer with pyloric stenosis. A 45-year-old male presented with left chest pain and dyspnea after forceful vomiting. Chest radiography and computed tomography (CT) revealed a massive left pleural effusion and left tension pneumothorax. Abdominal CT revealed pyloric stenosis with a remarkably dilated stomach. Tube thoracostomy and nasogastric suction were immediately performed and we selected conservative treatment based on the following factors—a stable general condition without sepsis, early diagnosis, and good drainage. Esophagogastroduodenoscopy on hospital day 9 demonstrated a healing ulcer in the lower esophagus and pyloric stenosis. We performed distal gastrectomy as elective surgery for pyloric stenosis due to a duodenal ulcer on hospital day 30. In summary, an esophageal perforation with contamination spreading to the thoracic cavity was successfully treated with conservative treatment.
Bibliography:ObjectType-Case Study-2
SourceType-Scholarly Journals-1
ObjectType-Feature-4
content type line 23
ObjectType-Report-1
ObjectType-Article-3
ISSN:1865-7257
1865-7265
1865-7265
DOI:10.1007/s12328-014-0493-3