Abstract
A 29-year old man was admitted to our hospital because of acute epigfattrric and retrosternal pain with fever. On the 2nd day after the onset, an esophageal ulcer or laceration and a small gastric ulcer were confirmed by endoscopy. Chemotherapy was started immediately. On the 8th day the diagnosis of Boerhaave's Syndorome was established by the leakage of barium meal into the mediastinum under fluoroscopy. He was treated only by intravenous antibiotics and peroral antiacid administration without surgical intervention. Endoscopic examination was repeated on the 19th and 42th day. At the last examination, only scar remained in the esophagus. In Japan, there are 117 reported cases of Boerhaave's Syndorome untill today and 22 cases (including ours') of them were observed by endoscopy. Eight among the 22 cases (36%) were healed by conservative way. However 4 of 14 patients who underwent surgical intervention were died. Boerhaave's Syndrome is required to be diagnosed and treated within 24 hours after its onset for saving the life. We emphasized the role and safty of early but careful endoscopy to confirm the position and dimension of esophageal rupture.
