Boerhaave's syndrome. Report of three cases

The incidence of Boerhaave's syndrome within esophageal perforations is low, but the mortality and morbidity may be high, depending on the time of diagnosis. Due to the particular anatomy of the esophagus, most ruptures occur in the lower third, close to the diaphragm. Diagnosis can usually be made from the esophagogram. We report three patients with Boerhaave's syndrome. All presented Candida infections, attributed to long periods of parenteral nutrition, broad spectrum antibiotic treatment, surgery and high oral and esophageal Candida colonization. Conservative treatment is reserved for patients with minimal symptoms, without communication between esophageal lumen and pleural space. Surgery most frequently consists of simple suture, Thal's technique, intrathoracic bipolar exclusion with staples or cervical esophagostomy with esophagectomy and jejunal nutrition.