Guideline for the diagnosis and treatment of patients with Boerhaave's syndrome

Spontaneous rupture of esophagus is a rare condition and is associated with a high mortality. The diagnosis and treatment of Boerhaave’s syndrome is a difficult problem and it has no single solution. The english and Russian articles about the problem to create the guideline for diagnosis and treatment of patients with Boerhaave’s syndrome were analyzed. The articles were found in «e-library» and «pubmed» on request «spontaneous rupture of esophagus» and «Boerhaave’s syndrome». Also own experience of treatment in the treatment of two patients was analyzed. Three steps algorithm for the diagnosis include: detection of main symptoms, differential diagnosis and final objective diagnosis of esophagus rupture. The algorithm may be undertaken in different level hospitals. The importance of determining hydropneumothorax on chest x-ray is accented. The guideline considers the ability of the hospital, the condition of the patient, localization and time of esophagus rupture. Advantages and disadvantages of the different treatment approach are also shown. Design of the guideline is presented in schema-view. Step-by-step the following the guideline algorithm allows to establish the diagnosis and to choose the optimal treatment option. The problem requires more extensive coverage in the literature and further study in order to compare the effectiveness of treatment approach and indications for them.