Treatment of 65-year-old male patient with Oesophagal (food pipe) tear due to increased internal pressure (Boerhaave Syndrome).
Salem, 09. February, 2024: Kauvery Hospital, Salem, which is part of a leading multi-specialty healthcare chain in Tamil Nadu, successfully performs treatment for “BoerhaaveSyndrome”
A 65-year-old patient with chest pain, vomiting, and sweating was admitted to Kauvery Hospital, Salem three months ago. Despite tests for cardiac disease, all results were negative, and a cardiologist examined him, ruled out the possibility of cardiac disease.
The patient was then seen by a gastro-enterologist, when it was found that he experienced chest pain and sweating after he forcibly tried to vomit. These are classic symptoms of a tear in the oesophagus, and we immediately did a CT scan with contrast dye, which confirmed the tear in the lower part of the oesophagus, possibly due to internal pressure (Boerhaave Syndrome).
This was followed by an emergency surgery after explaining the high risk of procedure and prolonged stay in hospital. First, the abdomen was opened and tear in the oesophagus was identified. After repairing the Oesophageal tear, Oesophagus was tied just below the repair to prevent stomach contents from travelling upwards. Then a small tube was fixed in stomach to prevent any residual fluid from traveling upwards. Then another tube was fixed in the small intestine for feeding purpose. Small incision was made in the neck and tube was placed in the oesophagus. Also, an incision was made in the neck region, the oesophagus in that region was tied and a small tube was inserted just above that to prevent saliva to go into the repaired Oesophagus.
So during the surgery there were totally 3 tubes inserted in his body and he was in the ICU for 2 days, and was discharged after 14 days in the hospital with advice of tube feeding through the tube in the small intestine.
The patient underwent a surgery and returned for follow-up visits two weeks after discharge. He showed progress and received recommendations for continued good health. Two months later, a CT scan showed he had healed well, and the tubes tied up during the surgery had opened naturally, allowing him to ingest the contrast dye orally. All three tubes were removed, and he resumed normal oral feeding.
Speaking of this DR. Ravikumar says that the point to note here is that chest pain, vomiting, and sweating are all symptoms that one normally associates with a heart attack, however it could be a symptom of a gastro-intestinal problem like oesophageal tear as well. There are several reasons for a tear in the oesophagus, it could be due to external factors – the upper part may sustain a tear due to endoscopy procedure, or any procedure that is performed could accidentally cause a pore or hole to occur etc. But for a tear to occur in the oesophagus on its own forcible vomiting could be a strong reason as it increases the pressure in the lower part of the oesophagus which is likely to cause a tear (Boerhaave Syndrome).
Facility Director of Kauvery Hospital, Salem, Mr. Selvam appreciated Dr. Ravikumar and his team at Kauvery Hospital, Salem, for the quick and precise diagnosis and treatment that helped restore the good health and confidence of the patient.
