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- W1513961027 abstract "Abstract Fourteen cases of “spontaneous” esophageal perforation from two hospitals over a twenty-five year period are reviewed. The classic syndrome, as described by Boerhaave, included overindulgence, forceful vomiting, and severe pleuritic pain followed by collapse and death. In our series, six patients appeared to follow a classic pattern, and in five of these, treatment was primary suture and healing occurred early. Eight cases did not follow the usual syndrome. In one of these cases, the patient died before treatment could be given, one patient presented with localized chronic perforation and responded to a gastric Thal patch, six required prolonged treatment including tube thoracotomy, rib resection, decortication, pharyngostomy, jejunostomy, gastrostomy, parenteral hyperalimentation, and pericardiectomy. Diagnosis was often confused by total lack of correlation between vomiting and pain. Almost all patients had some other abdominal problem or symptoms long before esophageal perforation. Diagnosis was confused with that of dissecting aneurysm, perforated ulcer, myocardial infarction, renal stone, and pleural effusion of unknown cause. One case presented nineteen days after perforation with constrictive purulent pericarditis. Of fourteen patients, one died almost immediately on arrival at the hospital, thirteen patients underwent operation, and eleven survived. Even in cases in which treatment is delayed by confusing presentations, the patient can survive, but vigorous treatment is needed and convalescence is prolonged. Although recognition of the classic Boerhaave syndrome is important, cases will be missed if reliance is placed solely on the usual criteria." @default.
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- W1513961027 date "1979-04-01" @default.
- W1513961027 modified "2023-10-14" @default.
- W1513961027 title "Reevaluation of the Boerhaave syndrome" @default.
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- W1513961027 doi "https://doi.org/10.1016/0002-9610(79)90131-4" @default.
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