scholarly journals INNOVATIVE DIAGNOSTIC METHODS FOR THE TREATMENT OF PATIENTS WITH BOERHAAVE SYNDROME AND ITS COMPLICATIONS

2021 ◽  
Vol 21 (4) ◽  
pp. 48-53
Author(s):  
К. G. Kubachev ◽  
В. A. Apereche ◽  
S M. Babaev
Keyword(s):  
Spontaneous Rupture ◽  
Diagnostic Methods ◽  
Vacuum Therapy ◽  
Esophageal Rupture ◽  
Treatment Results ◽  
Improve Treatment ◽  
Boerhaave Syndrome ◽  
Esophageal Stenting

Transluminal endoscopic interventions in the treatment of patients with spontaneous rupture of the esophagus can significantly improve treatment results. Esophageal stenting and vacuum therapy for the treatment of esophageal rupture and suture incompetence are alternatives to surgery.

P166 SPONTANEOUS ESOPHAGEAL RUPTURE – BOERHAAVE SYNDROME

2019 ◽  
Vol 32 (Supplement_2) ◽  
Author(s):  
B  Movchan ◽  
O Usenko ◽  
A Zgonnyk ◽  
R Vynogradov
Keyword(s):  
Spontaneous Rupture ◽  
Pleural Cavity ◽  
Clinical Manifestations ◽  
Esophageal Rupture ◽  
Esophageal Stents ◽  
Spontaneous Esophageal Rupture ◽  
Timely Diagnosis ◽  
Boerhaave Syndrome ◽  
Surgical Tactics ◽  
Effective Drainage

Abstract Aim To study the most effective method of treatment in patients with spontaneous rupture of the esophagus. Background The timely diagnosis of Boerhaave syndrome presents great difficulties due to its rarity, a variety of clinical manifestations, often simulating different pathologies from other organs and are difficult to treat. Methods From 2003 to 2019 9 patients with Bourhave's syndrome were treated at the clinic, primary care was provided to 6 patients in the community. All patients were admitted to the clinic with external left-sided esophageal-pleural fistula, 1 patient had a spontaneous rupture of the esophagus in the cliniс, the defect of the esophagus wall defect was completed, which led to successful results. Results Treatment in the remaining patients was started with adequate enteral nutrition and effective drainage of the pleural cavity. As a result of the use of pleural double-lumen drainage with active sanation with antiseptics and subsequent aspiration, with the exception of feeding through the mouth in four patients, it was possible to eliminate the esophageal-pleural fistula, profuse bleeding and death of the patient. Against the background of ongoing conservative therapy in two patients, it was not possible to eliminate the esophago-pleural fistula. A left-sided thoracotomy was performed with excision of the fistula with the decortication of the lung and the extirpation of the esophagus with the formation of an esophagostomy. Subsequently, these patients underwent retrosternal colic esophagoplasty. Two patients underwent Lewis surgery with drainage of the pleural cavity. Conclusion Boerhaave syndrome has a very high mortality rate, however, with a timely diagnosis and adequate surgical tactics, it develops into the formation of an esophageal-pleural fistula. In this case, the most effective treatment is excision of the fistulous course with extirpation of the esophagus and subsequent esophagoplasty. The use of esophageal stents is possible in extremely depleted patients or in elderly patients, due to the frequent occurrence of hypergranular esophagitis. Esophageal stents should be removed as soon as possible when confidence in the elimination of the esophageal-pleural fistula occurs.

Current methods of radiation diagnostics of traumatic bone injuries

2021 ◽  
pp. 30-38
Author(s):  
Igor A. Khokhlov ◽  
Ekaterina S. Milovanova
Keyword(s):  
Digital Technologies ◽  
Diagnostic Methods ◽  
Diagnostic Process ◽  
Treatment Results ◽  
Scientific Publications ◽  
Improve Treatment ◽  
Literary Sources ◽  
Combined Use ◽  
Examination Methods ◽  
Selection Of

The use of the latest digital technologies has contributed to the discovery of opportuni-ties for medicine based on earlier and detailed detection of pathological changes, which, in turn, has allowed to increase the effectiveness of the diagnostic process, improve treatment results and further prognosis. The progress of radiation diagnostics primarily contributed to the development of such a discipline as traumatology. The improvement of diagnostic algorithms, an integrated ap-proach to the selection of radiation examination methods made it possible to more fully examine patients with complex fractures, determine the nature of injuries, and choose the correct tactics and scope of surgery. The presented research provides an overview of current diagnostic methods used in traumatology and orthopedics, from classical radiography to the most modern imaging methods, such as magnetic resonance, computer tomography, scintigraphy. We gave examples of using different methods of research in detecting injuries of musculoskeletal system, carried out their comparative analysis, considered issues of combined use of several diagnostic methods, presented data on positive and negative aspects of their application, analyzed effectiveness of results. We obtained material for the analysis and writing of the literary review from scientific electronic databases: eLIBRARY, Scopus, Google Scholar, PubMed, RFFI Library, data from scientific publications of domestic and foreign authors. The depth of the search for literary sources was the period from 2008 to 2019.

scholarly journals Results of treatment for Boerhaave syndrome

2019 ◽  
Vol 27 (1) ◽  
pp. 66-74
Author(s):  
Aleksey V. Mikheev ◽  
Sergey N. Trushin
Keyword(s):  
Primary Care ◽  
Surgical Treatment ◽  
Spontaneous Rupture ◽  
Surgical Intervention ◽  
Esophageal Rupture ◽  
Results Of Treatment ◽  
Boerhaave Syndrome ◽  
The Moment ◽  
Suture Failure

Background. Spontaneous rupture of the esophagus (Boehaave syndrome, BS) is a rare pathology in the surgical practice. Esophageal rupture makes no more than 2-3% of all cases of damage to the esophagus and is associated with a significant number of diagnostic errors and with high mortality. Aim. The aim of the study was to analyze the quality of diagnostics and the results of treatment of patients with spontaneous rupture of the esophagus. Materials and Methods. We performed a retrospective analysis of medical histories and of treatment results of 10 patients with Boerhaave syndrome hospitalized in the department of thoracic surgery of the Ryazan Regional Clinical Hospital, Ryazan in 2007-2018. Results. Four of ten patients were transferred from other medical institutions. At the primary care stage six patients were misdiagnosed; two of them underwent diagnostic laparoscopy for suspicion of acute pancreatitis and perforated gastric ulcer. The average time from the onset of the disease to surgery was 71.723.4 hours. Closure of the esophageal perforation was performed in all cases. Regarding the timing of surgery, all patients with Boerhaave syndrome were divided into 2 groups: patients with early intervention (4 patients operated within 24 hours); patients with late intervention (5 patients operated after 48 hours from the onset of the disease). One patient underwent surgical treatment within 24 hours in a medical facility outside the Ryazan region. In nine out of ten patients the rupture was localized in a typical place in the lower third of the esophagus along the left lateral wall. In the postoperative period eight patients had complete or partial esophageal suture failure, which required prolonged inpatient treatment (54.712.1 days). Postoperative mortality was 10% (1 patient of 10) and was caused by the progressive multi-organ failure and the development of cerebral ischemic stroke. Conclusion. The quality of diagnostics of Boerhaave syndrome remains unsatisfactory: due to rare occurrence of this pathology, most specialists of primary care settings, including surgeons, are not well acquainted with the etiopathogenesis and peculiarities of clinical presentation of Boerhaave syndrome. Diagnostic and treatment errors in rendering primary medical assistance reaches 60%. Results of surgical treatment directly correlate with the time from the moment of perforation and development of septic complications. Even with early surgical intervention performed within 24 hours from the moment of perforation, esophageal suture failure may occur in up to 75% of cases. Thus, the success of treatment is determined by early diagnosis, timely hospitalization in a specialized facility, and adequate surgical intervention.

scholarly journals Endoluminal vacuum therapy in the management of an esophago-pleural fistula as a complication of Boerhaave syndrome in a patient with eosinophilic esophagitis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Carlos Tuñon ◽  
Juan De Lucas ◽  
Jan Cubilla ◽  
Rafael Andrade ◽  
Miguel Aguirre ◽  
...  
Keyword(s):  
Eosinophilic Esophagitis ◽  
Chronic Inflammatory Disease ◽  
Vacuum Therapy ◽  
Esophageal Rupture ◽  
Case Presentation ◽  
Boerhaave Syndrome ◽  
Uncommon Condition ◽  
Fistula Treatment ◽  
Novel Strategy ◽  
Esophageal Perforations

Abstract Background Boerhaave syndrome is an uncommon condition that represents about 15% of all esophageal perforation. A subset of these patients has eosinophilic esophagitis, a chronic inflammatory disease of the esophagus, that carries a risk of perforation of about 2%. Esophageal perforations can rarely result in the development of an esophago-pleural fistula. Treatment of esophago-pleural fistula represent a challenge due to lack of high quality evidence and scarce reported experience. Endoluminal vacuum-assisted therapy could have a role in the management by using the same principle applied in external wounds which provide wound drainage and tissue granulation. Case presentation We report a unique case of a 24-year-old man with eosinophilic esophagitis complicated with an esophageal rupture who developed an esophago-pleural fistula and was successfully managed with a non-surgical approach using endoluminal vacuum-assisted therapy. To our knowledge this could be the first experience reported in a patient with eosinophilic esophagitis. Conclusion Endoluminal vacuum-assisted therapy might be an effective and novel strategy in patients with eosinophilic esophagitis and esophago-pleural fistula as a consequence of Boerhaave syndrome. Appropriately designed studies are required.

scholarly journals Recurrent, Spontaneous Esophageal Ruptures Associated With Antiphospholipid Antibody Syndrome: Report of a Case

2014 ◽  
Vol 99 (6) ◽  
pp. 842-845 ◽  
Author(s):  
Hiroshi Naitoh ◽  
Minoru Fukuchi ◽  
Shinsuke Kiriyama ◽  
Takaharu Fukasawa ◽  
Yuichi Tabe ◽  
...  
Keyword(s):  
Spontaneous Rupture ◽  
English Literature ◽  
Antiphospholipid Antibody ◽  
Antiphospholipid Antibody Syndrome ◽  
Esophageal Rupture ◽  
Vascular Thrombosis ◽  
Spontaneous Esophageal Rupture ◽  
Increased Risk ◽  
Boerhaave Syndrome ◽  
Syndrome Report

Abstract A 52-year-old man was admitted to our hospital with a spontaneous esophageal rupture (Boerhaave syndrome) and was successfully treated. Eight years after the first incident, he was readmitted with a recurrent rupture. Recurrence of Boerhaave syndrome is extremely rare, with only 7 cases reported in the English literature. During treatment, the patient was also diagnosed with antiphospholipid syndrome (APS). Although APS is known to cause a variety of symptoms due to vascular thrombosis, recurrence of Boerhaave syndrome, coincident with APS, has never been reported. The pathogenesis of Boerhaave syndrome has not been clearly determined. This report serves to increase awareness of the risk of APS, which results in an increased risk of spontaneous rupture of the esophagus.

scholarly journals Laparoscopic surgery by spontaneous rupture of the esophagus, a case report of treatment Boerhaave syndrome

2020 ◽  
Vol 7 (10) ◽  
pp. 3442
Author(s):  
Eduard A. Galliamov ◽  
Igor V. Semenyakin ◽  
Sergey A. Erin ◽  
Evgeniy A. Kytirev ◽  
Grigorii Y. Gololobov ◽  
...  
Keyword(s):  
Laparoscopic Surgery ◽  
Spontaneous Rupture ◽  
Positive Response ◽  
Response To Treatment ◽  
Esophageal Rupture ◽  
Invasive Approach ◽  
Perforation Hole ◽  
Spontaneous Esophageal Rupture ◽  
Somatic Status ◽  
Boerhaave Syndrome

Spontaneous rupture of the esophagus, Boerhaave syndrome, is a rare pathology and emergency condition for the patient. Patient, 63-year-old, on the 6th day of the disease falls into the clinic, where a Boerhaave syndrome was diagnosed. Laparoscopic surgery was performed. Sanitation and drainage of the mediastinum, suturing of the perforation hole were performed. After the operation, а positive response to treatment was observed. A group of authors believes that a minimally invasive approach to the treatment of spontaneous esophageal rupture is the alternative method for patients with severe somatic status and a small perforated opening of the esophagus.

Some aspects of diagnosis and treatment of a сircumscribed form of choroidal hemangioma complicated by macular edema

2021 ◽  
pp. 240-246
Author(s):  
J.A. Magaramov ◽  
◽  
R.A. Loginov ◽  
O.B. Klepinina ◽  
◽  
...  
Keyword(s):  
Visual Acuity ◽  
Optic Nerve ◽  
Macular Edema ◽  
Subretinal Fluid ◽  
Diagnostic Methods ◽  
Treatment Results ◽  
Transpupillary Thermotherapy ◽  
Choroidal Hemangioma ◽  
Nasal Side ◽  
Intraretinal Cysts

Introduction. The interest are rare cases of a сircumscribed choroidal hemangioma located juxtapapillary (JP) on the nasal side of the optic nerve disc (OND) and complicated by macular edema. Purpose. Studying the possibility of timely diagnosis and evaluating the effectiveness of treatment of a сircumscribed choroidal hemangioma complicated by macular edema. Material and methods. A retrospective analysis of the diagnostics and treatment results of 5 patients (5 eyes) with JP сircumscribed choroidal hemangioma, localized on the nasal side of the optic disc, complicated by macular edema, was carried out. Results. As a result, in all patients, already 1 month after the session of selective laser transpupillary thermotherapy (TTT), an increase in visual acuity and quality was observed, which was accompanied by pronounced resorption of intraretinal cysts and / or subretinal fluid in the macula. Conclusion. The purposeful use of modern diagnostic methods and the use of a sparing method of laser TTT makes it possible to identify and cure patients with CPCH complicated by macular edema without loss of visual functions. Key words: сircumscribed choroidal hemangioma, selective transpupillary thermotherapy, cystic macular edema.

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