Boerhaave syndrome medical therapy: Difference between revisions
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==Medical Therapy== | ==Medical Therapy== | ||
*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 should be instituted. | **[[Intravenous fluids]] should be instituted. | ||
**Antibiotics: Imipenem/cilastatin | **Antibiotics: '''[[Imipenem-Cilastatin|Imipenem/cilastatin]]''' | ||
**Nasogastric suction | **[[Nasogastric aspiration|Nasogastric suction]] | ||
**Keep the patient NPO. | **Keep the patient [[NPO]]. | ||
**Adequate drainage with tube thoracostomy or formal thoracotomy. | **Adequate drainage with tube thoracostomy or formal [[thoracotomy]]. | ||
*The decision to use a conservative or surgical approach depends on the following factors: | *The decision to use a conservative or surgical approach depends on the following factors: | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Mohamed Diab, MD [2]
Overview
Conservative management of Boerhaave syndrome consists of: intravenous fluids should be instituted, antibiotics, nasogastric suction, keeping the patient NPO, adequate drainage with tube thoracostomy or formal thoracotomy.
Medical Therapy
- Conservative management of Boerhaave syndrome consists of:[1][2]
- Intravenous fluids should be instituted.
- 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
|month=ignored (help)