Laparoscopic repair of esophageal perforation due to Boerhaave syndrome

Abstract

Boerhaave syndrome is the spontaneous transmural rupture of the esophagus due to an increase in intraesophageal pressure when vomiting against a closed glottis. There are various methods of managing it, with the main principles of limiting sepsis, draining the area, and maintaining nutrition. These include conservative management, open repair with drain insertion, and laparoscopic repair, depending on the timing of presentation and the amount of sepsis. Although the gold standard is open thoracotomy and/or laparotomy, we present a case where an esophageal rupture, presenting within 24 hours and hemodynamically stable, was managed with laparoscopic repair and drain insertion with good results. There is a paucity of literature regarding this mode of management and we have discussed the various options available in literature. We conclude that this is a safe and viable option in the management of Boerhaave syndrome in a nonseptic patient presenting early.