Year 2017 / Volume 109 / Number 5
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An unusual cause of Boerhaave´s syndrome in a young patient

376

Samuel Fernandes, Carlos Noronha Ferreira, José Freire, José Velosa,

Abstract
An 18-year-old male patient with a history of atopy and intermittent dysphagia for solids, presented to the emergency department with sudden onset total dysphagia followed by hematemesis, after ingesting an ibuprofen tablet. Urgent upper gastrointestinal endoscopy revealed a deep laceration just above the tablet impacted in the distal esophagus. Abdominal CT-scan confirmed the suspicion of an esophageal perforation. The impacted tablet was broken up with biopsy forceps, and a covered metallic stent (Hanarostent® 60/100x20/26mm) was placed across the cardia effectively excluding the fistula. Recovery was uneventful and the stent was easily removed 6 weeks later. Follow-up biopsies showed marked mucosal infiltration by eosinophils confirming the diagnosis of eosinophilic esophagitis (EE). The patient was treated with oral budesonide and remains asymptomatic.
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References
1. Lucendo A, Friginal-Ruiz A, Rodríguez B. Boerhaave's syndrome as the primary manifestation of adult eosinophilic esophagitis. Two case reports and a review of the literature. Diseases of the Esophagus. 2011;24(2):E11-E15.
2. Runge T, Eluri S, Cotton C, et al. Causes and Outcomes of Esophageal Perforation in Eosinophilic Esophagitis. Journal of Clinical Gastroenterology. 2016 (In press).
3. Jacobs J, Fatima H, Cote G, et al. Stenting of Esophageal Perforation in the Setting of Eosinophilic Esophagitis. Digestive Diseases and Sciences. 2014;60(4):1098-1100.
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Fernandes S, Noronha Ferreira C, Freire J, Velosa J. An unusual cause of Boerhaave´s syndrome in a young patient. 4512/2016


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Publication history

Received: 25/06/2016

Accepted: 01/11/2016

Published: 03/05/2017

Article revision time: 122 days

Article editing time: 312 days


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