Boerhaave's Syndrome Complicated with Mediastinitis: A Case Report

自發性食道破裂合併縱膈腔發炎：病例報告

侯民波(Min-Po Ho) ； 蔡光超(Kuang-Chau Tsai) ； 張益誠(Yih-Chen Chang)

《中華民國急救加護醫學會雜誌》 16卷3期 (2005/09) Pp. 123-128

https://doi.org/10.30018/JECCM.200509.0005

摘要

自發性食道破裂(Boerhaave's syndrome)是臨床上一種罕見的疾病。通常劇烈嘔吐後發生胸部，腹部疼痛以及皮下氣腫是典型自發性食道破裂的案例。我們報告一位61歲男性病患因厲害嘔吐後發生自發性食道破裂(Boerhaave's syndrome)合併縱膈腔發炎。初步診斷方法是照站立胸部X光，以及做胸部電腦斷層攝影。食道攝影通常用來確認食道有無破裂，並且可以評估破裂的位置。雖然本病患有合併縱膈腔發炎，緊急手術加上廣泛抗生素治療是唯一可救活病患的生命，病患一個月後安全出院。

關鍵字

Boerhaave's症候群 ； 自發性食道破裂 ； 縱膈腔發炎

並列摘要

Boerhaave's syndrome (spontaneous rupture of the esophagus) is a rare clinical entity that frequently presents with an antecedent history of forceful vomiting, followed by chest or abdominal pain. We report on a 61-year-old male patient who experienced spontaneous rupture of the esophagus after an episode of forceful protracted vomiting. The diagnosis was confirmed by radiographic studies of the chest in the upright position and a computed tomographic scan of the chest. A water-soluble contrast study of the esophagus was done to confirm the diagnosis and the site of rupture. Early aggressive surgical intervention and broad-spectrum antibiotics resulted in the survival of the patient, although the patient experienced the complication of mediastinitis. He was discharged in relatively good condition 1 month after his admission.

並列關鍵字

Boerhaave's syndrome ； spontaneous rupture of the esophagus ； mediastinitis