RESUMO
Spontaneous perforation of the esophagus (Boerhaave syndrome) is a rare disease that poses a serious surgical challenge. The analysis of literature concerning the Boerhaave syndrome reveled cases of recurrent spontaneous perforation of the esophagus. The incidental nature of this condition calls for more accurate assessment of all such cases. The authors made a detailed evaluation of the data obtained from eight reports of recurrent Boerhaave syndrome. The data is presented as a summary table comparing the clinical course and outcomes of patients with the primary Boerhaave syndrome as well as recurrent Boerhaave syndrome.
Assuntos
Procedimentos Cirúrgicos do Sistema Digestório/história , Perfuração Esofágica/história , Esofagectomia/história , Ruptura Espontânea/história , Perfuração Esofágica/cirurgia , Feminino , História do Século XVIII , História do Século XIX , História do Século XX , Humanos , Masculino , Radiografia Torácica/história , SíndromeRESUMO
Spontaneous rupture of the esophagus is a rare devastating condition, which was first described by Herman Boerhaave in 1724. Only a handful of cases were recorded during the 18th and 19th centuries. Diagnosis was usually obtained on autopsy. Only in 1914 Irving Walker achieved the first antemortem diagnosis of spontaneous rupture of the esophagus. The dawn of thoracic surgery during the first decades of the 20th century opened up the way for operative cure. More than 200 years after Boerhaave's initial report, Barrett as well as Clagett and Olsen independently accomplished the first successful surgical treatment by primary repair of the esophageal lesion in 1947. Since those pioneer days, various suggestions for proper treatment have been made ranging from conservative, nonoperative means to extended procedures such as esophagectomy. Invention of minimally invasive surgery and endoscopic measures has further broadened the spectrum of available therapeutic options. The aim of this history article is to outline the development of diagnosis and management of spontaneous rupture of the esophagus from the age of Herman Boerhaave to the present times.
Assuntos
Perfuração Esofágica/história , Esofagectomia/história , Áustria , Perfuração Esofágica/cirurgia , História do Século XVIII , História do Século XIX , História do Século XX , Humanos , Ruptura Espontânea/história , Ruptura Espontânea/cirurgia , SíndromeRESUMO
Not much more than a century ago, a ruptured ectopic pregnancy was a death sentence. In 1876, John Parry wrote in his book on this subject: 'Here is a wife in the most useful period of her existence, which good authorities have said is never cured; and for which, even in this age when science and art boast of such high attainments, no remedy, either medical or surgical, has been tried with a single success'. When we read that eminent authorities were advising the use of electric shocks, injection of narcotics into the sac and copious and frequent bleeding, one is hardly suprised. Parry himself suggested that the only remedy would be to open the abdomen and either tie the bleeding vessels or remove the sac entirely.
