Boerhaave syndrome medical therapy: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Boerhaave syndrome}} | {{Boerhaave syndrome}} | ||
{{CMG}} {{AE}} {{DM}}, {{Ajay}}, {{FT}} | {{CMG}} {{AE}} {{DM}}, {{Ajay}}, {{FT}}, {{SHH}} | ||
==Overview== | ==Overview== | ||
Conservative management of Boerhaave syndrome consists of | Conservative management of [[Boerhaave syndrome]] consists of [[intravenous fluids]], [[antibiotics]], [[Nasogastric aspiration|nasogastric suction]], keeping the patient [[NPO]], adequate drainage with tube thoracostomy or formal [[thoracotomy]]. | ||
==Medical Therapy== | ==Medical Therapy== | ||
Non-operative treatment is best approach for patients with a contained perforation and the absence of clinical [[mediastinitis]].<ref name="pmid20226056">{{cite journal |vauthors=Malik UF, Young R, Pham HD, McCon A, Shen B, Landres R, Mahmoud A |title=Chronic presentation of Boerhaave's syndrome |journal=BMC Gastroenterol |volume=10 |issue= |pages=29 |year=2010 |pmid=20226056 |pmc=2847967 |doi=10.1186/1471-230X-10-29 |url=}}</ref> | |||
*The decision to use a conservative or surgical approach depends on the following factors: | Conservative management of Boerhaave syndrome consists of: <ref name="pmid17220586">{{cite journal |author=Matsuda A, Miyashita M, Sasajima K, ''et al.'' |title=Boerhaave syndrome treated conservatively following early endoscopic diagnosis: a case report |journal=Journal of Nippon Medical School = Nihon Ika Daigaku zasshi |volume=73 |issue=6 |pages=341–5 |year=2006 |pmid=17220586 |url=http://www.jstage.jst.go.jp/article/jnms/73/6/73_341/_article|doi=10.1272/jnms.73.341}}</ref><ref>{{cite journal |author=Jougon J, Mc Bride T, Delcambre F, Minniti A, Velly JF |title=Primary esophageal repair for Boerhaave's syndrome whatever the free interval between perforation and treatment |journal=Eur J Cardiothorac Surg |volume=25 |issue=4 |pages=475–9 |year=2004 |month=April |pmid=15037257 |doi=10.1016/j.ejcts.2003.12.029 |url=http://linkinghub.elsevier.com/retrieve/pii/S1010794003008170}}</ref> | ||
* | *[[Intravenous fluids]] | ||
* | *Antibiotics ([[Imipenem-Cilastatin|Imipenem/cilastatin]]) | ||
* | *[[Nasogastric aspiration|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== | ==References== | ||
Latest revision as of 20:15, 17 February 2021
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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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