Ghaziabad: Two patients with rare cases of ruptured esophagus, also known as Boerhaave syndrome, were successfully operated on in a private city hospital and are now recovering.
The patients over 50 years of age underwent a series of operations at Max Hospital that lasted 12 hours to repair damage to the esophagus (gullet), lungs and parts of the body where stomach contents (acidic nature) had accumulated .
Doctors said Boerhaave syndrome was rare and extremely fatal, with the death rate of those left untreated or without surgery being close to 100%. It requires very complex thoracic surgery to restore the esophagus and remove acid build-up in other parts of the body.
The two cases were reported to the hospital just days apart. On July 14th, Sanjay Nigam, 53, a resident of Vigyan Vihar, Delhi, ate a burger late at night and went to sleep.
He later vomited and felt severe pain in his stomach and chest, which prevented him from getting up.
He was taken to Max Hospital in Vaishali and after a series of tests that ruled out a heart attack, a CT scan and X-ray revealed that he had suffered a ruptured esophagus and needed immediate surgery.
In the second case, Ashok Kumar Chandak, 61, a resident of Nehru Nagar in Ghaziabad, checked into a hotel in Sahibabad with his family on July 18 to attend a wedding. At night he ate a light meal of chapati, legumes, and rice and fell asleep. At around 2:30 am, he complained of indigestion and vomited twice. He complained of severe back pain and began to knock. Concerned about having a heart attack, his relatives took him to the hospital, where Boerhaave syndrome was also diagnosed.
Dr. Sharad Joshi, Chief Physician of the Department of Pulmonology, Max Vaishali, said: “Both patients had symptoms after vomiting, including severe chest and back pain. Diagnosis is difficult because the symptoms are similar to those of a heart attack. A CT scan with an oral contrast agent confirmed this. Chest tubes were placed to drain the collected fluid around the lungs, and later the patients underwent marathon surgery to repair the damage. ”
A rupture of the esophagus after vomiting is a fatal complication with a mortality rate of up to 70%. Delays in diagnosis and definitive treatment can prove fatal, added Dr. Joshi added.
Dr. Roman Dutta, senior physician in thoracic and robotic thoracic surgery, said the patients underwent three operations – a thoracotomy to repair the esophagus, a video-assisted thoracoscopic operation to remove accumulations of stomach contents from the lungs, and an operation to attach an esophagus to provide food to patients. “Patients are fed through this tube for six weeks and are allowed to take semi-solid foods by mouth after recovery. After a full recovery, they can eat normally, ”he said.
Survival depends on the size of the perforation, the amount of leak, and when to get medical attention. “Patients should be admitted to the hospital if they complain of pain with vomiting,” added Dr. Dutta added.
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