The patient was admitted with respiratory failure, continuous hiccups, severe shortness of breath, and vomiting after drinking alcohol. Initially, the symptoms were easily mistaken for cardiovascular or respiratory conditions. However, through clinical examination, laboratory tests, imaging, and endoscopy, doctors diagnosed a spontaneous esophageal rupture – a highly dangerous surgical emergency.

Dr. Nguyen Xuan Hoa, Deputy Director of the Center for Digestive Surgery and Pelvic Floor Disorders, stated that the case was particularly complex because the lesion was located in the lower one-third of the esophagus, a difficult area to access. The team had to weigh between a thoracic or abdominal surgical approach. After in-depth consultation and careful endoscopic evaluation, the doctors decided to use an abdominal approach to dissect and suture the esophagus.

This surgical technique demands high experience, as the abdominal route only allows access to the esophagus within a range of 8-10 cm. Incorrectly assessing the lesion's position could lead to significant difficulties for the surgeon during treatment.

“The most critical factor with Boerhaave’s syndrome is time,” Dr. Hoa said. “If diagnosed within the initial 24 hours, the chances of preserving the esophagus and saving the patient’s life are much higher.”

Five days after surgery, the patient was able to sit up, and his chest drain was removed. Follow-up imaging showed good esophageal healing with no leakage. The patient’s gastric tube was removed, and he began oral feeding, expecting to resume normal eating and drinking within 3-4 weeks.

Doctors operate on the patient. *Photo: Thao My*

Previously, when diagnostic imaging, anesthesia, resuscitation, and surgical techniques were limited, many patients died or suffered severe complications. Today, thanks to advancements in modern diagnosis, specialized surgical expertise, and intensive care, most patients are successfully saved.

Doctors explain that the common mechanism of Boerhaave’s syndrome is severe vomiting after heavy alcohol consumption, which causes a sudden increase in pressure within the esophagus, leading to a tear or rupture. The danger lies in the initial symptoms, which may only be chest pain, shortness of breath, or hiccups, often leading to complacency.

People should avoid alcohol abuse. If, after drinking, symptoms such as persistent vomiting, chest pain, shortness of breath, or prolonged hiccups occur, it is crucial to seek immediate medical attention at a healthcare facility specializing in digestive and esophageal conditions for timely diagnosis and treatment to prevent the risk of death.

Le Nga