SUCCESSFUL ENDOSCOPIC CLIPPING FOR BOERHAAVE'S SYNDROME WITH PLEURAL RUPTURE

Abstract

A 46-year-old woman with abdominal pain, left shoulder pain, and dyspnea after vomiting was diagnosed with Boerhaave's syndrome at the emergency department of our hospital. A chest computed tomography scan revealed extraluminal air from the mediastinum to the cervical region and widespread pleural contamination. We performed pleural drainage accordingly and observed a 10-mm tear under esophagography. We treated the patient conservatively based on her stable general condition and good drainage. As the inflammatory reaction persisted for 4 days after admission, we performed endoscopic clipping, which effectively closed the tear. The treatment course was uneventful, and the patient was discharged from the hospital after we endoscopically confirmed complete healing of the esophageal ulcer. We present a case of Boerhaave's syndrome with pleural rupture and contamination that was successfully treated with endoscopic clipping.