متلازمة بوررهاف مع عدم استقرار الديناميكا الدموية أو الإنتان الشديد: عندما لا يمكن تجنب الجراحة

References

DOI: 10.1186/s13017-019-0245-2

• Spontaneous esophageal perforation (Boerhaave syndrome) is most often due to an abrupt increase in the esophageal pressure following a vomiting effort in the absence of relaxation of the superior esophageal sphincter.
• Surgery should be undertaken in all patients who do not meet NOM criteria (Grade 1C).
• If direct repair of thoracic EP is not feasible (hemodynamic instability, delayed surgical exploration, extensive esophageal damage) esophageal exclusion, diversion, or resection should be performed (Grade 1C).
• Complete esophageal diversion or thoracic esophageal resection is required in the presence of large esophageal disruption; creation of a cervical esophagostomy and feeding jejunostomy are mandatory in these patients.