Boerhaave-ov sindrom – rijetki uzrok retrosternalne boli

Adna Kafedžić

doi:10.5937/pomc17-28156

Adna Kafedžić JU Opća bolnica "Prim. dr. Abdulah Nakaš" Sarajevo

DOI: https://doi.org/10.5937/pomc17-28156

Ključne reči: Boerhaave-ov sindrom, perforacija ezofagusa, pneumomedijastinum, dijagnoza

Sažetak

Akutna bol u grudnom košu je jedan od najvećih izazova u dijagnostičkom i terapijskom smislu zbog zbog brojnih diferencijalno-dijagnostičkih mogućnosti. Boerhaave-ov sindrom je rijetko, ali istovremeno jedno od najletalnijih oboljenja gastrointestinalnog trakta. Iz tog razloga je potreban visok nivo sumnje kod pacijenata sa prezentujućom retrosternalnom boli. Klasični simptomi poput povraćanja, boli u grudnom košu i supkutanog emfizema ne moraju uvijek biti prisutni. Pristup pacijentu sa Boerhaave-ovim sindromom je multidisciplinaran. Pacijentu je potrebna hitna rehidracija, antibiotski tretman i konsultacija specijaliste hirurgije. Tretman je zasnovan na kliničkoj slici pacijenta, lokaciji i veličini perforacije, a najvažniji prognostički faktor je vrijeme postavljanja dijagnoze. Još uvijek ne postoje zvanične smjernice za tretman ovog stanja, a znanja o mogućnostima tretmana su zasnovana na pojedinačnim prikazima slučaja iz literature.

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