Abstract
We report a case of esophageal perforation (Boerhaave syndrome) caused by vomiting related to a duodenal ulcer with pyloric stenosis. A 45-year-old male presented with left chest pain and dyspnea after forceful vomiting. Chest radiography and computed tomography (CT) revealed a massive left pleural effusion and left tension pneumothorax. Abdominal CT revealed pyloric stenosis with a remarkably dilated stomach. Tube thoracostomy and nasogastric suction were immediately performed and we selected conservative treatment based on the following factors—a stable general condition without sepsis, early diagnosis, and good drainage. Esophagogastroduodenoscopy on hospital day 9 demonstrated a healing ulcer in the lower esophagus and pyloric stenosis. We performed distal gastrectomy as elective surgery for pyloric stenosis due to a duodenal ulcer on hospital day 30. In summary, an esophageal perforation with contamination spreading to the thoracic cavity was successfully treated with conservative treatment.
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Conflict of Interest:
Ryo Tanaka, Shin-ichi Kosugi, Daisuke Sato, Hiroshi Hirukawa, Tetsuya Tada, Hiroshi Ichikawa, Takaaki Hanyu, Takashi Ishikawa, Takashi Kobayashi and Toshifumi Wakai declare no conflict of interest.
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All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008(5).
Informed Consent:
Informed consent was obtained from all patients for being included in the study.
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Tanaka, R., Kosugi, Si., Sato, D. et al. Conservative treatment of esophageal perforation related to a peptic ulcer with pyloric stenosis. Clin J Gastroenterol 7, 295–298 (2014). https://doi.org/10.1007/s12328-014-0493-3
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DOI: https://doi.org/10.1007/s12328-014-0493-3