Korean Journal of Gastrointestinal Endoscopy 1999;19(3): 414-420.
경비위관이 파열부를 관통한 Boerhaave 증후군 1 예 - 응급수술 없이 생존한 증례 - ( A Case of Boerhaave's Syndrome Involving Nasogastric Tube Penetration into the Pleural Cavity )
김경진, 김효종, 송민수, 고관표, 황일섭, 동석호, 김병호, 장영운, 이정일, 장린 (Kyeong Jin Kim, Hyo Jong Kim, Min Su Song, Kwan Pyo Koh, Il Seop Hwang, Seok Ho Dong, Byung Ho Kim, Young Woon Chang, Jeoung Il Lee and Rin Chang)
Abstract
Boerhaave's syndrome, spontaneous esophageal rupture, is lethal and associated with a 70% survival rate despite emergent surgical management in recent reports. Early diagnosis and management is critical for more favorable outcome. But, it is difficult to diagnose early because of the low incidence and lack of specific symptoms and signs. We experienced 37 year-old male patient with Boerhaave's syndrome who was heavy drinker, and suffered from chronic renal failure. He visited a hospital because of hematemesis and severe back pain. He was transferred to our hospital with a nasogastric tube insertion, which was penetrating the distal esophagus. A radiologic examination revealed that the distal tip was located in the left pleural cavity. It was assumed that the tube had passed through the preexisting perforation site. Operation was not performed emergently due to delay in diagnosis and severe hyperkalemia. The patient was in a septic condition, but had recovered slowly after systemic broad spectrum antibiotic therapy, pleural drainage and intrapleural antibiotic injections. An esophagography revealed no leakage of gastro-grafin on the 14th hospital day, and he later completely recovered from sepsis. (Korean J Gastrointest Endosc 19: 414∼420, 1999)
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