• Journal of Chest Surgery
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• v.34 no.11
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• pp.879-882
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• 2001

advancement in the treatment of esophageal perforation due to the development of ICU care and antibiotics. There were controversies in the treatment of esophageal perforation when diagnosed after 24hrs. From 1995 to 2000, we performed a buttressed primary repair and mediastinal drainage in 6 Boerhaave\`s syndrome patients among 13 esophageal perforation patients. Two patients died(33%). They died because of pneumonia, ARDS and sepsis on 38th, 39th post-operative day respectively. Two patients had leak at the site of repair which was treated completely with conservative treatment. We report on the result of a buttressed primary repair and mediastinal drainage for 6 Boerhavve\`s syndrome patients.

• Korean Journal of Bronchoesophagology
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• v.18 no.1
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• pp.9-12
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• 2012

Boerhaave's syndrome is a very fatal condition occuring esophageal rupture during emesis and has the worst prognosis of the esophageal perforation. From May 2007 to March 2012 11 patients underwent surgical treatment for Boerhaave's syndrome at Inje University Sanggye Paik Hospital. There were 11 males whose mean age was 49.9 years ranging from 42 to 59. 2 cases of primary closure was performed and 9 cases of anastomosis using EEA (Esophago-Enteric Anastomisis) stapler. Mean operation time was 154.4 minutes and one patient who undergone primary repair died because of mediastinitis and sepsis on $35^{th}$ post-operative day. There was no leakage at other patients. Post-operative complication was one operative wound infection and one post-operative bleeding which was treated completely. Surgical treatment for Boerhaave's syndrome using EEA stapler is simple and effective technique but further studies with large number of cases should be carried out for better outcome.

• Journal of Chest Surgery
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• v.23 no.5
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• pp.1040-1046
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• 1990

Despite the improved diagnostic and treatment modalities recently introduced for a variety of esophageal disorders, a perforation or leak from the esophagus remains a sources of morbidity and mortality regardless of the cause of leak. After the perforation of esophagus, the contamination of mediastinum and pleural cavity with food, bacteria and corrosive gastric juice leads to sepsis and cardiopulmonary dysfunction. The early diagnosis and early treatment are very important, and the delayed treatment leads to high risk of morbidity and mortality. We experienced one case of esophageal perforation, after forced vomiting in 48 years old male patient. We used omentum on the treatment of ruptured esophagus, and it was successfully managed.

• Journal of Chest Surgery
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• v.25 no.8
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• pp.812-818
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• 1992

The spontaneous rupture of the esophagus is an uncommon disease, but without early diagnosis and treatment, the mortality rate is high. This report is on the two cases treated at the Department of Thoracic and Cardiovascular Surgery, College of Medicine, Kyu-ngpook National University. The first patient, after heavy drinking, had vomiting followed by chest pain, dyspnea and subcutaneous emphysema. After diagnosis using an esophagogram, an operation was perfomed. About a 4cm rupture was found at the lower left part of the esophagus and was primarily sutured with the intercostal muscle. The patient was weaned from the ventilator after 40 hours. The second patient had symptoms the same as the first case. Six days after the app-earence of the symptoms, the patient was treated by the Thais onlay gastric patch method. The leakage happened after the surgery and he received a conservative treatment. After discharge no abnormalities, such as leakage and stricture, were found on the eso-phagogram The two patients now live a normal life.

• Journal of Chest Surgery
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• v.21 no.5
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• pp.935-940
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• 1988

Perforated esophagus is a surgical emergency; it is the most serious and frequently the most rapidly lethal perforation of the gastrointestinal tract. Contamination of the mediastinum and often a pleural cavity with corrosive fluids, food material and bacteria leads to cardiorespiratory embarrassment, shock, major fluid losses and fulminating infection. Despite the improved diagnostic and treatment modalities, a perforation or leak from the esophagus remains a major source of morbidity and mortality. When esophageal perforation occurs, a successful outcome can be expected only when it is diagnosed soon after the event and repaired early. Esophageal perforations have a poor prognosis after delayed surgical treatment. With the use of the Thai onlay gastric patch method, a case of postemetic spontaneous perforation of the esophagus was successfully managed 6days after the event.

• Journal of Chest Surgery
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• v.39 no.3 s.260
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• pp.214-219
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• 2006

Background: Perforation of esophagus is relatively uncommon. but it is associated with high morbidity and mortality. Treatment and outcome are largely determined by the time of presentation. We performed a retrospective review of patients with esophageal perforation to assess the outcome of current management techniques. Material and Method: A retrospective chart review was performed on all patients treated for perforation of esophagus from March 1990 to March 2005. There were 28 patients (22 men and 6 women: mean age 51 years, range 17 to 82 years) The causes of the perforations were as follows: foreign body retention (9 patients), trauma (7 patients), spontaneous rupture (7 patients), and iatrogenic (5 pati-ients). 18 patients were presented within 24 hours and 10 patients were presented after 24 hours., Esophageal repair was performed in 21 ($75\%$) of them, 4 patients were treated with esophagectomy, 3 patients were treated with feeding gastrostomy and drainage. Result: Hospital mortality was $18\%$ and iatrogenic was increase the mortality rate (p < 0.05). Site of perforation, time from perforation, and treatment method had no influence on mortality. Postoprative leaks occurred in 4 patients after primary repair and were treated conservatively. Conclusion: Esophageal perforation remains a devastating event which is difficult to diagnose and manage. Primary repair can be performed in most patients with esophageal perforation regardless of time to presentation with a low mortality. Accurate diagnosis and early treatment are essential to the successful management of patients.

• Journal of Chest Surgery
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• v.40 no.9
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• pp.655-658
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• 2007

Esophageal perforation is relatively uncommon but it often cause fatal if not properly treated, and it is associated with high morbidity and mortality. We report here on two cases of esophageal perforation caused by Boerhaave syndrome or pneumatic dilatation for treating achalasia. The patients were successfully treated with thoracoscopic primary repair and esophagomyotomy.