2 operated upon for ruptured food pipes

Ghaziabad: Two patients who had rare cases of ruptured food pipe, also known as Boerhaave Syndrome, underwent successful surgeries at a private city hospital and are now recovering.
The patients, aged over 50 years, underwent a series of surgeries spanning over 12 hours at Max Hospital to repair the damage to oesophagus (food pipe) as well as lungs and body parts where gastric contents (acidic in nature) had accumulated.
Doctors said Boerhaave’s Syndrome is rare and extremely lethal, wherein the mortality rate of those untreated or without surgery is almost 100%. It requires a very complex thoracic surgery to restore the food pipe and remove acid accumulation in other parts of the body.
The two cases were reported just a few days apart at the hospital. On July 14, Sanjay Nigam (53), a resident of Delhi’s Vigyan Vihar, ate a burger late at night and went to sleep.
He vomited later and experienced severe pain in his stomach and chest, due to which he could not get up.
He was brought to Max Hospital in Vaishali and after a series of tests that ruled out heart attack, it was discovered in a CT scan and X-ray that he had suffered a ruptured food pipe and needed immediate surgery.
In the second case, Ashok Kumar Chandak (61), a resident of Nehru Nagar in Ghaziabad, checked into a hotel on July 18 in Sahibabad along with his family to attend a wedding. At night, he took a light meal of chapati, pulses and rice and went to sleep. Around 2.30am, he complained of indigestion and vomited twice. He complained of severe back pain and started palpitating. Worried that he had a heart attack, his relatives rushed him to hospital, where he was also found to be suffering from Boerhaave’s Syndrome.
Dr Sharad Joshi, principal consultant, pulmonology department, Max Vaishali, said, “Both patients had symptoms, including severe chest and back pain, after vomiting episodes. The diagnosis is challenging as symptoms are similar to those of heart attack. A CT scan with oral contrast confirmed it. Chest tubes were placed to drain the collected fluid around lungs and later the patients underwent a marathon surgery to repair the damage.”
A food pipe rupture following a vomiting episode is a fatal complication, with mortality as high as 70%. Delay in diagnosis and definitive management may prove fatal, Dr Joshi added.
Dr Roman Dutta, senior consultant, thoracic and robotic thoracic surgery, said patients underwent three surgeries – thoracotomy to repair the food pipe, video-assisted thoracoscopic surgery to remove accumulation of gastric contents from lungs and a surgery to attach a food pipe to provide nutrition to patients. “The patients are fed through this pipe for six weeks and after recovery, they are allowed semi-solid food through the mouth. After full recovery, they can eat normally,” he said.
The survival depends on the size of perforation, amount of leakage and when medical help is given. “Patients should be rushed to hospital if they complain of pain with vomiting,” Dr Dutta added.