Pyopneumothorax revealing Boerhaave syndrome
Journal Title: JOURNAL OF FUNCTIONAL VENTILATION AND PULMONOLOGY - Year 2018, Vol 9, Issue 27
Abstract
The pleuro-digestive fistulas are entities little described in the literature. These are diagnostic and therapeutic emergencies that put the patient's vital prognosis in the short term. We report a case of oesopharyngeal fistula revealed by a left pyopneumothorax in a 58-year-old HIV-positive patient on the second line of treatment. A triad of signs constitutes Boerhaave syndrome: forceful vomiting, chest pain and subcutaneous emphysema. The syndrome results from spontaneous rupture of oesophageal wall leading to an oeso-pleural or oeso-mediastinal fistula. Positive diagnosis is carried by the esogastric transit to water-soluble substance. Boerhaave's syndrome is a surgical emergency. We report here on a case of spontaneous rupture of the esophagus whose late diagnosis resulted in therapeutic complications but whose clinical management evolved favorably in spite of these complications. Aerodigestive fistula is a major complication of surgery. BOERHAAVE syndrome, a rare pathology, should be sought in any patient with chest pain with the notion of vomiting. Chest X-ray and oesogastroduodenal transit should be performed urgently in order to quickly establish a diagnosis that guarantees a good prognosis even in PvVIH.
Authors and Affiliations
Maïga Soumaïla
Keywords
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- EP ID EP570015
- DOI 10.12699/jfvpulm.9.27.2018.42
- Views 73
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