title: A late diagnosed case of Spontaneous esophageal perforation in an elderly patient.
abstract: Spontaneous esophageal perforation, also known as Boerhaave's syndrome, is a rare but potentially life-threatening condition, especially in elderly patients with more complications, speedy development and higher mortality. Successful handling of the disease depends on a timely diagnosis and the appropriate choice of treatment. Unfortunately, late diagnosis is common because of the non-specific clinical presentation. We here present a 72-year-old patient of spontaneous esophageal perforation who complained of chest pain, but sharply deteriorated with septic shock. With a vomiting history and gastrointestinal-genic bacterium identified in the chest fluid, the patient was highly suspected for esophageal perforation, though the oral methylene blue test was negative for three times. The diagnosis was finally established by esophagoscopy on the 10(th) day. The perforation was successfully healed by active conservative management and the patient was discharged home on the 43(rd) day eating normal diet.
authors.affiliation: Department of Geriatrics, Xinhua Hospital affiliated to Shanghai Jiaotong University School of Medicine Shanghai, China.
authors.forename: Lu
authors.initials: L
authors.lastname: Wei
authors.affiliation: Department of Geriatrics, Xinhua Hospital affiliated to Shanghai Jiaotong University School of Medicine Shanghai, China.
authors.forename: Fei
authors.initials: F
authors.lastname: Wang
authors.affiliation: Department of Geriatrics, Xinhua Hospital affiliated to Shanghai Jiaotong University School of Medicine Shanghai, China.
authors.forename: Shuyan
authors.initials: S
authors.lastname: Chen
keywords: Boerhaave’s syndrome; Spontaneous esophageal perforation; chest pain; conservative management; septic shock