The patient experienced unusual Boerhaave’s syndrome, a condition in which the esophagus ruptures due excess retching and committing resulting in perforation of food pipe, which is life threatening complication

Dr. Roy Patankar, a renowned Gastroenterologist and Director of Zen Multispecialty Hospital in Chembur, Mumbai, led a team that accomplished a successful surgery on a 60-year-old woman from New Zealand. The patient had been diagnosed with Boerhaave’s syndrome, a rare condition causing a ruptured esophagus, and was previously reliant on a feeding tube. Following the procedure, the patient regained the ability to eat orally.

7 months ago, patient Mrs Priya Kapoor (name changed)*, a resident of New Zealand experienced vomiting and chest pain. She consulted multiple doctors who initially misdiagnosed her with right empyema thorax (accumulation of pus in the pleural space between the lung and chest wall). Back there in February and March 2023, she underwent two right thoracotomy surgeries, which involved making an incision between the ribs to access the lungs or other organs within the thoracic cavity. During these procedures, the chest drain revealed food contents which were leaking through the esophagus.

As there was free leak of food contents into chest cavity leading to severe infection ( medically called mediastinitis) which has very high death rate (upto 30-40% mortality) to control infection due to this reason, she underwent complete diversion of esophagus and its disconnection from stomach and she was fed through tube all these months.

Dr Roy Patankar, Leading Gastroenterologist, GI & Robotic Surgeon, Zen Multispeciality Hospital said, “The patient was unable to eat orally because her esophagus and stomach were disconnected during a previous operation. The food pipe was open in the neck and the stomach tube was open on the anterior abdominal wall. Therefore, the patient relied on tube feeding. An endoscopy revealed a 5cm perforation (hole) in the esophagus. Additionally, she had left vocal cord palsy. Previous CT scans did confirm this diagnosis.

Dr Patankar added, “This rare syndrome occurs when there is a rupture of the esophagus due to extreme stress on the food pipe due to retching, excessive vomiting. Common symptoms include Severe retching and intractable vomiting, accompanied by chest pain in acute onset. Thus, the patient underwent surgery to get back on track.

During the procedure, the abdomen was open, the stomach was disconnected, and a new food pipe was made using the stomach and then that was taken through the chest just below the sternum bone in the neck. A new passage was created between the remnant of the food pipe and the newly made food pipe. Post-surgery patient was in ICU and on a ventilator for a day and then gradually recovered.

She started oral on day 5 and gradually went on a full diet by mouth within 10 days. After this treatment, the patient is eating everything by mouth without feeding through any tubes,” highlighted Dr Patankar.

“It was disheartening to have to consume only liquid and pureed meals. Following the doctor’s instructions, my family members would feed me at regular intervals. My hope dwindled as I believed I would never be able to eat normally again.  However, all these hardships came to an end when I sought assistance from Zen Hospital where the doctors promptly diagnosed and treated me. The overwhelming emotions that flooded over me when I took that first mouthful of food after seven long months cannot be described in words as it truly was an indescribable feeling of joy and relief. I can fully enjoy eating my favorite foods without any trouble” concluded the patient Mrs Priya Kapoor (name changed)*.