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Role of Endoscopy in the Management of Boerhaave Syndrome
Juan Ignacio Tellechea,Jean-Michel Gonzalez,Pablo Miranda-García,Adrian Culetto,Xavier Benoit D’Journo,Pascal Alexandre Thomas,Marc Barthet 대한소화기내시경학회 2018 Clinical Endoscopy Vol.51 No.2
Boerhaave syndrome (BS) is a spontaneous esophageal perforation which carries high mortality. Surgical treatment is well established,but the development of interventional endoscopy has proposed new therapies. We expose our experience in a Gastrointestinal andEndoscopy Unit. With a retrospective, observational, open-label, single center, consecutive case series. All patients diagnosed withBS who were managed in our center were included. Treated conservatively, endoscopically or surgically, according to their clinicalcondition and lesion presentation. Fourteen patients were included. Ten were treated with primary surgery. One conservatively. In total,7/14 patients required an endoscopic treatment. All required metallic stents deployment, 3 cases over-the-scope-clips concomitantlyand one case a novel technique an internal drain. 6/7 cases endoscopically treated achieved complete esophageal healing. In conclusion,endoscopy is an useful tool at all stages BS management: difficult diagnosis, primary treatment in selected patients and as salvage whensurgery fails. With mortality rates and outcomes comparables to surgery.