Patient with ruptured food pipe saved at Rela Hospital
August 9, 2023
CHENNAI, August 7, 2023: Surgeons at Rela Hospital have performed a very complex and challenging lifesaving surgery on a 75-year-old man suffering from a ruptured esophagus, the tubular organ (food pipe) through which food travels from the mouth to the stomach.
The extremely rare condition, called Boerhaave Syndrome, is fatal if not treated urgently. It is usually caused by a person placing excessive strain or stress on the esophagus, such as when vomiting repeatedly or forcefully. This causes the wall of the esophagus to split open. Substances like food particles, bacteria, and digestive acids, which are toxic to rest of the body, begun to leak into the chest or abdomen, causing serious infection and almost certain death.
The patient, Mr. Rajagopalan CV, was working as Scientific Officer at Indira Gandhi Centre for Atomic Research before retirement. He has been leading a physically fit and active lifestyle that included a daily walk of 5 km. A few days ago, he was struck by recurrent bouts of vomiting and diarrhea. He soon began to suffer from rapid breathing and heart rate, low blood pressure and excruciating pain below the chest. He was rushed by family members to a nearby nursing home, from where doctors referred him to Rela Hospital for urgent attention. Upon arrival, the patient was attended to by a team of medical experts led by Dr. Jimmy Prabhakaran, Senior Consultant – General Medicine & Internal Medicine, Rela Hospital.
Said Dr. Jimmy Prabhakaran: “The patient’s condition was perplexing, considering his history of leading a healthy lifestyle and not having any medical problems. After a thorough investigation, we arrived at the astonishing diagnosis of Boerhaave Syndrome, a condition that affects only 0.0003% of the population and is not often encountered in the medical world. Prompt medical attention is very important. Patients treated within 24 hours of suffering an esophageal rupture have a survival rate of 75%. This drops to 50% after 24 hours and 10% after 48 hours.”
Advanced imaging tests, including a contrast-enhancing CT scan, showed a large tear in the lower end of the patient’s esophagus. It was leading to the build-up of fluid in the lining of the chest cavity (pleural effusion) and life-threating complications. The patient was immediately wheeled into the operating theatre. The tear was so big, endoscopy was ruled out. The Surgical team lead by Dr. Perungo opted to conduct a thoracotomy that lasted four hours and involved direct repair of the esophageal tear.
Though the patient suffered from mediastinitis (inflammation of the chest cavity), his condition steadily improved after surgery. Eating anything from the mouth was out of the question, so a gastrostomy tube was used to deliver nutrition directly to his stomach. The patient continued to be fed this way for six months to allow esophagus to heal. After this period, another surgery called re-anastomosis was conducted to fully cure the patient. Mr. Rajagopalan CV has now returned to oral feeding and completely recovered.
Said the patient Rajagopalan CV: “The medical emergency came as a shock to me because of the kind of healthy lifestyle I have been leading for decades. I understand it is a very rare occurrence and early diagnosis and treatment is critical. I thank the doctors of Rela Hospital from the bottom of my heart for acting promptly, conducting the complex surgery and saving my life.”
Said Dr. Jimmy Prabhakaran: “This remarkable case is a testament to the high capabilities of our medical team, the advanced facilities at our hospital, and the indomitable human spirit. Boerhaave Syndrome remains an elusive and complex medical condition. Our success in treating Mr. Raja Gopal showcases our commitment to providing world-class healthcare.”