Korean J Gastrointest Endosc.  2000 Mar;20(3):198-202.

A Case of Esophagopleural Fistula Treated by Endoscopic Injection of Histoacryl in Boerhaave's Syndrome

• Lee ES
• Lee DH
• Shin SY
• Lee YW
• Choi W
• Kim PS
• Kim YS
• Kim HK
• Kim IH

Abstract

Boerhaave's syndrome is a spontaneous tear through all the layers of the left lateral wall of the esophagus just above the diaphragm, produced by a sudden increase in esophageal pressure. Boerhaave's syndrome is a rare but grave syndrome, with a mortality rate around 40%. Most affected patients are middle-aged men who experience violent vomiting after heavy eating or alcohol intake or both. Vomiting followed by the abrupt onset of pain, dyspnea, and/or shock are the major symptoms. The most important diagnostic tool may be an upright chest X-ray. However, esophagograms and/or a chest CT may be required to locate the lesion. The management of esophagopleural fistula must be individualized, and both the patient's condition and the specific characteristics of the fistula must be considered. Successful management of patients must include adequate nutritional support and effective therapy of the associated empyema. A case of esophagopleural fistula complicated by Boerhaave's syndrome, which was successfully treated by endoscopic injection of Histoacryl , in herein reported.

Keyword

Boerhaave's syndrome; Esophagopleural fistula; Histoacryl; Endoscopic injection

MeSH Terms

Diaphragm
Dyspnea
Eating
Empyema
Enbucrilate*
Esophagus
Fistula*
Humans
Male
Mortality
Nutritional Support
Shock
Thorax
Tomography, X-Ray Computed
Vomiting
Enbucrilate