Endoluminal vacuum therapy in the management of an esophago-pleural fistula as a complication of Boerhaave syndrome in a patient with eosinophilic esophagitis.

Abstract

BACKGROUND:

Boerhaave syndrome is an uncommon condition that represents about 15% of all esophageal perforation. A subset of these patients has eosinophilic esophagitis, a chronic inflammatory disease of the esophagus, that carries a risk of perforation of about 2%. Esophageal perforations can rarely result in the development of an esophago-pleural fistula. Treatment of esophago-pleural fistula represent a challenge due to lack of high quality evidence and scarce reported experience. Endoluminal vacuum-assisted therapy could have a role in the management by using the same principle applied in external wounds which provide wound drainage and tissue granulation.

CASE PRESENTATION:

We report a unique case of a 24-year-old man with eosinophilic esophagitis complicated with an esophageal rupture who developed an esophago-pleural fistula and was successfully managed with a non-surgical approach using endoluminal vacuum-assisted therapy. To our knowledge this could be the first experience reported in a patient with eosinophilic esophagitis.

CONCLUSION:

Endoluminal vacuum-assisted therapy might be an effective and novel strategy in patients with eosinophilic esophagitis and esophago-pleural fistula as a consequence of Boerhaave syndrome. Appropriately designed studies are required.

• Authors: Carlos Tuñon, Juan De Lucas, Jan Cubilla, Rafael Andrade, Miguel Aguirre, Julio Zúñiga Cisneros
• Journal: BMC gastroenterology (BMC Gastroenterol) Vol. 21 Issue 1 Pg. 484 (Dec 20 2021) ISSN: 1471-230X [Electronic] England
• PMID: 34930127 (Publication Type: Case Reports, Journal Article)
• Copyright: © 2021. The Author(s).

Topics

• Adult
• Eosinophilic Esophagitis
• Esophageal Perforation (etiology, therapy)
• Fistula
• Humans
• Male
• Mediastinal Diseases
• Negative-Pressure Wound Therapy
• Young Adult