Boerhaave syndrome medical therapy
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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.[1] Conservative management of Boerhaave syndrome consists of: [2][3]
- 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
- ↑ 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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