Presentation of Boerhaave's syndrome as an upper-esophageal perforation associated with a right-sided pleural effusion:A case report  

作　　者：Ni Tan Yin-Hua Luo Guang-Cai Li Yi-Lin Chen Wei Tan Yue-Hua Xiang Liang Ge Di Yao Ming-Hua Zhang 

机构地区：[1]Pulmonary and Critical Care Medicine,Central Hospital of Tujia and Miao Autonomous Prefecture,Hubei University of Medicine,Enshi Autonomous Prefecture 445000,Hubei Province,China [2]Cardiovascular Disease Center,Central Hospital of Tujia and Miao Autonomous Prefecture,Hubei University of Medicine,Enshi Autonomous Prefecture 445000,Hubei Province,China

出　　处：《World Journal of Clinical Cases》2022年第18期6192-6197,共6页世界临床病例杂志

基　　金：Supported by the Natural Science Foundation of Hubei Province,No.2019CFB798。

摘　　要：BACKGROUND Spontaneous esophageal rupture or Boerhaave’s syndrome is a rare and acute disease with a high incidence of misdiagnosis and mortality.Here,we aimed to explore the clinical characteristics,diagnosis,treatment,and prognosis of spontaneous esophageal rupture,and to analyze the causes of misdiagnosis during the treatment of spontaneous esophageal rupture.CASE SUMMARY The clinical features of the patient with spontaneous esophageal rupture misdiagnosed earlier as pleural effusion were retrospectively analyzed and the reasons for misdiagnosis are discussed based on a current review of the literature.The patient was admitted to a local hospital due to shortness of breath accompanied by vomiting and abdominal distension for five hours.Based on the computed tomography(CT)scan analysis,clinically,right pleural effusion was diagnosed.However,the patient was unwilling to undergo right closed thoracic drainage.The patient also had intermittent fevers against infection,and during the course of treatment,he complained of chest pain,following which,he was transferred to our hospital.Grapefruit-like residue drainage fluid was observed.Re-examination of the chest CT scans suggested the presence of spontaneous perforation in the upper left esophagus.Therefore,the patient underwent an urgent esophageal hiatus repair.Unfortunately,the patient died of infection and respiratory failure due to progressive dyspnea after surgery.CONCLUSION Spontaneous esophageal rupture is a rare disease associated with high fatality.The patients do not present typical clinical symptoms and the disease progresses rapidly.This case report highlights the importance of a dynamic review of chest CT scan,not only for the initial identification of segmental injury but also for prioritizing subsequent treatment strategies.Moreover,we have presented some clues for clinicians to recognize and diagnose spontaneous esophageal rupture at rare sites(upper-esophageal segment)through this case report of spontaneous esophageal rupture that caused the patien

关 键 词：Spontaneous esophageal rupture Chest computed tomography Upper-esophageal perforation Right-sided pleural effusion MISDIAGNOSIS Case report 

分 类 号：R655.4[医药卫生—外科学]