Variants of surgical tactics and structural changes in the esophageal wall in the Burhaave syndrome

Two clinical cases of surgical tactics options for Burhaаve syndrome (spontaneous perforation of the esophagus) are presented. The assessment of the status of patients, the nature of interventions, the results of histological examination and the outcomes of the disease was carried out.In both cases, the reason for hospitalization in the thoracic department was a spontaneous rupture of the esophagus, complicated by mediastinitis and pleural empyema.The first patient, 59 years old, underwent esophageal extirpation with the imposition of gastro- and esophagostomy. Сlinical recovery has been achieved with the reconstructive surgery was performed. The second patient, 69 years old, underwent conservative treatment. On the 7th day, there was an arrosive bleeding. A thoracolaparotomy and suturing of the esophageal defect were urgently performed. In the postoperative period, there was a progressive deterioration with the death for the esophageal sutures leak and coronary syndrome.