Boerhaave syndrome medical therapy: Difference between revisions
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==Medical Therapy== | ==Medical Therapy== | ||
Nonoperative treatment is best approach for patients with a contained perforation and the absence of clinical mediastinitis. | |||
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> | 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]] | *[[Intravenous fluids]] | ||
Revision as of 15:59, 6 February 2018
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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
Nonoperative treatment is best approach for patients with a contained perforation and the absence of clinical mediastinitis.
Conservative management of Boerhaave syndrome consists of: [1][2]
- Intravenous fluids
- Antibiotics (Imipenem/cilastatin)
- Nasogastric suction
- Keep 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:
- Time delay in presentation and diagnosis
- Extent of perforation
- Overall medical condition of the patient
References
- ↑ 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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