Man successfully treated for Boerhaave syndrome

When 56-year-old Uday (name changed) was taken to hospital with retching, vomiting with severe chest and abdominal pain along with breathing difficulties, he thought he was suffering from a heart-related ailment.

After tests, including a chest X-ray and CT scan of the thorax and abdomen, doctors at BGS Gleneagles Global Hospitals found a tear in the lower food pipe — a condition called Boerhaave syndrome.

Doctors immediately performed a surgery on Uday to drain the accumulated pus and treat the tear in the oesophagus. When Uday was recovering from the surgery, further investigation found a hole in his lower oesophagus, leaving doctors with fewer treatment options as he had just had a surgery. In the end, doctors opted for a newer endoscopic modality involving ‘over-the-scope clipping’.

A 45-minute procedure by Dr Adarsh C K, consultant gastroenterologist and hepatologist, and his team corrected the leakage in the food pipe by fixing a metal stent on the tear in the food pipe, thereby helping it heal better.

As a result, the patient was able to take oral feed within a few days. Uday also recovered in a few months and gained weight. Doctors could endoscopically remove the metal stent three months later.

Boerhaave syndrome is prevalent in 3.1 cases per 10,00,000 a year. It occurs when a person forcefully retches or vomits or coughs vigorously. Overindulgence in food and alcohol are the major risk factors for spontaneous perforation of the oesophagus.

Doctors said people with a history of increased intra-oesophageal pressure, followed by chest pain or breathing difficulty should be tested for Boerhaave syndrome.