title: Successful closure of spontaneous esophageal rupture (Boerhaave's syndrome) by endoscopic ligation with snare loops.
abstract: BACKGROUND
  Spontaneous esophageal rupture is a rare condition with a high mortality rate, and it is generally treated by surgery. In the present report, successful non-surgical closure of spontaneous esophageal rupture by endoscopic ligation with snare loops in a patient with pyopneumothorax and septicemia is presented.
  
  
  METHODS
  The case of an 80-year-old man patient with spontaneous esophageal rupture who was cured by endoscopic ligation with snare loops is reported. The patient was admitted with severe chest pain. Chest CT scan revealed pneumomediastinum, and an upper gastrointestinal series using gastrografin showed leakage of contrast medium from the lower esophagus. Therefore, a diagnosis of spontaneous esophageal rupture to the thorax was made. Since the family refused surgery, the patient was treated conservatively. Since extensive blood in the stool was noted on day 5, an emergency endoscopic examination was performed. Clipping was performed around the perforation, and the clips were ligated with snare loops. The patient was discharged on day 83 without recurrence.
  
  
  RESULTS
  We suggest that endoscopic ligation with snare loops should be chosen for elderly people and high-risk cases.
authors.affiliation: Gastroenterology and Surgical Oncology, Ehime University School of Medicine, Shitsukawa, Toon City, Ehime 791-0295 Japan.
authors.forename: Jun
authors.initials: J
authors.lastname: Kuwabara
authors.affiliation: Gastroenterology and Surgical Oncology, Ehime University School of Medicine, Shitsukawa, Toon City, Ehime 791-0295 Japan.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Watanabe
authors.affiliation: Gastroenterology and Surgical Oncology, Ehime University School of Medicine, Shitsukawa, Toon City, Ehime 791-0295 Japan.
authors.forename: You
authors.initials: Y
authors.lastname: Kojima
authors.affiliation: Departments of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Toon City, Japan.
authors.forename: Naoyuki
authors.initials: N
authors.lastname: Higaki
authors.affiliation: Departments of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Toon City, Japan.
authors.forename: Yoshiou
authors.initials: Y
authors.lastname: Ikeda
authors.affiliation: Gastroenterology and Surgical Oncology, Ehime University School of Medicine, Shitsukawa, Toon City, Ehime 791-0295 Japan.
authors.forename: Kouichi
authors.initials: K
authors.lastname: Sato
authors.affiliation: Gastroenterology and Surgical Oncology, Ehime University School of Medicine, Shitsukawa, Toon City, Ehime 791-0295 Japan.
authors.forename: Motohira
authors.initials: M
authors.lastname: Yoshida
authors.affiliation: Gastroenterology and Surgical Oncology, Ehime University School of Medicine, Shitsukawa, Toon City, Ehime 791-0295 Japan.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Yamamoto
authors.affiliation: Gastroenterology and Surgical Oncology, Ehime University School of Medicine, Shitsukawa, Toon City, Ehime 791-0295 Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kikuchi
keywords: Conservative therapy; Snare; Spontaneous esophageal rupture