Boerhaave syndrome medical therapy
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Mohamed Diab, MD [2], Ajay Gade MD[3]], Feham Tariq, MD [4], Shaghayegh Habibi, M.D.[5]
Overview
Conservative management of Boerhaave syndrome consists of intravenous fluids, antibiotics, nasogastric suction, keeping the patient NPO, adequate drainage with tube thoracostomy or formal thoracotomy.
Medical Therapy
Non-operative treatment is best approach for patients with a contained perforation and the absence of clinical mediastinitis.[1]
Conservative management of Boerhaave syndrome consists of: [2][3]
- Intravenous fluids
- Antibiotics (Imipenem/cilastatin)
- Nasogastric suction
- Keeping the patient NPO
- Adequate drainage with tube thoracostomy or formal thoracotomy
The decision to use a conservative or surgical approach depends on the following factors:
- Delay in presentation and diagnosis
- Extent of perforation
- Overall medical condition of the patient
References
- ↑ Malik UF, Young R, Pham HD, McCon A, Shen B, Landres R, Mahmoud A (2010). “Chronic presentation of Boerhaave’s syndrome”. BMC Gastroenterol. 10: 29. doi:10.1186/1471-230X-10-29. PMC 2847967. PMID 20226056.
- ↑ Matsuda A, Miyashita M, Sasajima K; et al. (2006). “Boerhaave syndrome treated conservatively following early endoscopic diagnosis: a case report”. Journal of Nippon Medical School = Nihon Ika Daigaku zasshi. 73 (6): 341–5. doi:10.1272/jnms.73.341. PMID 17220586.
- ↑ Jougon J, Mc Bride T, Delcambre F, Minniti A, Velly JF (2004). “Primary esophageal repair for Boerhaave’s syndrome whatever the free interval between perforation and treatment”. Eur J Cardiothorac Surg. 25 (4): 475–9. doi:10.1016/j.ejcts.2003.12.029. PMID 15037257. Unknown parameter
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