Use of reversed latissimus dorsi muscle flap for primary oesophageal repair reinforcement in Boerhaave's syndrome

Aim Boerhaave's syndrome, or spontaneous oesophageal rupture, is a rare but serious condition. The pathology involved is a complete, transmural laceration of the oesophagus. The overall mortality rates are still high (range: 10–60 per cent). Outcomes of oesophageal perforations depend on the du...

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Bibliographic Details
Published in:Surgical practice 2017-11, Vol.21 (4), p.161-163
Main Authors: Kok, Amy Siu‐Yan, Wong, Jeff Siu‐Wang, Chow, Tam‐Lin
Format: Article
Language:English
Subjects:
Boerhaave's syndrome
Esophagus
latissimus dorsi
muscle flap
oesophagus
Surgical outcomes
Throat surgery
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Summary:Aim Boerhaave's syndrome, or spontaneous oesophageal rupture, is a rare but serious condition. The pathology involved is a complete, transmural laceration of the oesophagus. The overall mortality rates are still high (range: 10–60 per cent). Outcomes of oesophageal perforations depend on the duration between diagnosis of perforation and treatment. Primary repair has been identified as the best treatment option, especially for presentation before 24 h. Mediastinal pleura, gastric fundus, pericardial flap and intercostal muscle flap are frequently used. Reversed latissimus dorsi (LD) muscle flap is another feasible option, especially when the intercostal muscle is inadequate and the length of perforation is long. Patients and Methods A patient presented with Boerhaave's syndrome with left posterolateral thoracotomy done. Intraoperation found a 4‐cm, full‐thickness perforation over the distal oesophagus. Primary repair and reinforcement with reversed LD muscle flap was performed. Results The patient had an uneventful recovery. Water‐soluble contrast enema confirmed no leakage. He was discharged on postoperative day 10. Conclusion Primary repair and reinforcement with reversed LD muscle flap is a feasible option when the intercostal muscle is inadequate and the length of the oesophageal perforation is long.
ISSN:1744-1625
1744-1633
DOI:10.1111/1744-1633.12279