Boerhaave syndrome associated with portal hypertension with varicose veins of the esophagus

Spontaneous rupture of the esophagus is a disease that directly threatens the patient's life. One of the earliest descriptions of the beginning of the XVIII century belongs to the Dutch physician H. Burchaave. A clinical case of treatment of a female patient with spontaneous rupture of the esophagus (Burhave syndrome) against the background of cirrhosis of the liver and significant varicose veins of the esophagus is presented. When using extracavitary vacuum therapy, rapid epithelialization of the esophageal rupture site was noted, followed by regression of the cavity in the mediastinum. This could be facilitated by a specific thickening of the wall caused by varicose veins of the esophagus.

Subsequently, on the 12th day of follow-up, the patient developed massive bleeding from varicose veins of the cardiac stomach, and therefore underwent emergency surgery. The fatal outcome was due to the development of postoperative complications against the background of severe initial pathology. According to autopsy data, complete healing of the esophageal defect and resolution of mediastinitis were noted.

Thus, in such a serious life-threatening condition as spontaneous rupture of the esophagus, varicose veins can play the role of a protective factor in the form of temporary tamponade of the injury zone and prevent the lightning-fast development of mediastinitis.