Digestive Diseases and Sciences

, Volume 63, Issue 5, pp 1139–1142 | Cite as

(Re)building the Wall: Recurrent Boerhaave Syndrome Managed by Over-the-Scope Clip and Covered Metallic Stent Placement

  • Monique T. Barakat
  • Mohit Girotra
  • Subhas BanerjeeEmail author
Stanford Multidisciplinary Seminars

Case Presentation and Evolution

A 62-year-old man was initially evaluated at a local hospital complaining of shortness of breath and severe, persistent pain in the chest and epigastric regions with radiation to the left shoulder and neck. The pain was exacerbated by hiccupping, coughing and deep inspiration. He reported heavy alcohol consumption and recurrent migraine headaches the night before and that the pain had followed a protracted episode of retching and vomiting. His past medical history was notable for a 4-cm ascending aortic aneurysm and two previous episodes of esophageal rupture occurring under similar circumstances. The first episode of perforation had occurred 12 years previously and was managed with chest tube placement and antibiotics. The second, which had occurred 4 years previously, had resulted in a tracheo-esophageal fistula that was managed by endoscopic stent placement and right-sided empyema requiring thoracotomy with decortication and debridement. The...


  1. 1.
    de Schipper JP, Pull ter Gunne AF, Oostvogel HJ, et al. Spontaneous rupture of the oesophagus: Boerhaave’s syndrome in 2008. Literature review and treatment algorithm. Dig Surg. 2009;26:1–6.CrossRefPubMedGoogle Scholar
  2. 2.
    Thorbjarnarson B. The Mallory-Weiss and Boerhaave syndromes. N Y State J Med. 1986;86:285–286.PubMedGoogle Scholar
  3. 3.
    Tonolini M, Bianco R. Spontaneous esophageal perforation (Boerhaave syndrome): diagnosis with CT-esophagography. J Emerg Trauma Shock. 2013;6:58–60.CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Wise MP, Salmon JB, Maynard ND. Boerhaave syndrome: a diagnostic conundrum. BMJ Case Rep. 2009. doi: 10.1136/bcr.07.2008.0375.PubMedPubMedCentralGoogle Scholar
  5. 5.
    Dickinson KJ, Buttar N, Wong Kee Song LM, et al. Utility of endoscopic therapy in the management of Boerhaave syndrome. Endosc Int Open. 2016;4:E1146–E1150.CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Schweigert M, Beattie R, Solymosi N, et al. Endoscopic stent insertion versus primary operative management for spontaneous rupture of the esophagus (Boerhaave syndrome): an international study comparing the outcome. Am Surg. 2013;79:634–640.PubMedGoogle Scholar
  7. 7.
    Vyslouzil K, Kral V, Neoral C, et al. Surgical treatment of spontaneous esophageal perforation—Boerhaave syndrome. Rozhl Chir. 2000;79:521–523.PubMedGoogle Scholar
  8. 8.
    Kimberley KL, Ganesh R, Anton CK. Laparoscopic repair of esophageal perforation due to Boerhaave syndrome. Surg Laparosc Endosc Percutan Tech. 2011;21:e203–e205.CrossRefPubMedGoogle Scholar
  9. 9.
    Kobara H, Mori H, Rafiq K, et al. Successful endoscopic treatment of Boerhaave syndrome using an over-the-scope clip. Endoscopy 2014;46:UCTN:E82-3.Google Scholar
  10. 10.
    Haito-Chavez Y, Law JK, Kratt T, et al. International multicenter experience with an over-the-scope clipping device for endoscopic management of GI defects (with video). Gastrointest Endosc. 2014;80:610–622.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  • Monique T. Barakat
    • 1
  • Mohit Girotra
    • 1
  • Subhas Banerjee
    • 1
    Email author
  1. 1.Division of Gastroenterology and HepatologyStanford University School of MedicineStanfordUSA

Personalised recommendations