{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T19:10:38Z","timestamp":1789153838689,"version":"build-2803163510"},"reference-count":12,"publisher":"BMJ","issue":"7","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,6,26]]},"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:p>Boerhaave\u2019s syndrome or spontaneous perforation of the oesophagus is a life-threatening condition that carries high mortality. Delayed diagnosis has a mortality rate of 20%\u201350%. While surgical intervention has been the mainstay of treatment, advancements in endoscopy and oesophageal stenting have allowed for alternative management. Our case involves a 33-year-old man with self-induced emesis and DKA. After 10 days in the ICU, he developed a large right pleural effusion, which was treated with chest tube placement. Upper GI study confirmed delayed Boerhaave\u2019s syndrome. A self-expanding stent was inserted followed by percutaneous endoscopic gastrostomy (PEG) for decompression and jejunal extension for nutrition. He developed empyema and underwent right thoracotomy for washout and lung decortication. Stent was exchanged once due to recurrent leak following migration and removed after 40 days. Endoscopic stent placement with PEG with jejunal extension followed by thoracotomy is a viable alternative to primary repair of delayed oesophageal perforation.<\/jats:p>","DOI":"10.1136\/bcr-2021-244122","type":"journal-article","created":{"date-parts":[[2021,7,13]],"date-time":"2021-07-13T12:50:49Z","timestamp":1626180649000},"page":"e244122","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Alternative management of delayed spontaneous oesophageal perforation by endoscopic stenting"],"prefix":"10.1136","volume":"14","author":[{"given":"Christina","family":"Zhu","sequence":"first","affiliation":[{"name":"Texas Tech University Health Sciences Center School of Medicine, Lubbock, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adan","family":"Castrodad","sequence":"additional","affiliation":[{"name":"Department of Surgery, Texas Tech University Health Sciences Center, Covenant Medical Center, Lubbock, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2989-5293","authenticated-orcid":false,"given":"Ariel P","family":"Santos","sequence":"additional","affiliation":[{"name":"Department of Surgery, Texas Tech University Health Sciences Center, Covenant Medical Center, Lubbock, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,7,13]]},"reference":[{"key":"2025082802271980000_14.7.e244122.1","doi-asserted-by":"publisher","DOI":"10.1016\/S1091-255X(03)00110-0"},{"key":"2025082802271980000_14.7.e244122.2","doi-asserted-by":"publisher","DOI":"10.1016\/0003-4975(89)90119-7"},{"key":"2025082802271980000_14.7.e244122.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2011.01.082"},{"key":"2025082802271980000_14.7.e244122.4","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2003.08.037"},{"key":"2025082802271980000_14.7.e244122.5","doi-asserted-by":"crossref","first-page":"E92","DOI":"10.1055\/s-0043-124075","article-title":"Non-Surgical management of Boerhaave's syndrome: a case series study and review of the literature","volume":"6","author":"Aloreidi","year":"2018","journal-title":"Endosc Int Open"},{"key":"2025082802271980000_14.7.e244122.6","doi-asserted-by":"publisher","DOI":"10.1007\/s005950170217"},{"key":"2025082802271980000_14.7.e244122.7","doi-asserted-by":"publisher","DOI":"10.1111\/j.1442-2050.2008.00918.x"},{"key":"2025082802271980000_14.7.e244122.8","doi-asserted-by":"publisher","DOI":"10.1111\/j.1442-2050.2004.00382.x"},{"key":"2025082802271980000_14.7.e244122.9","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5223(96)70407-5"},{"key":"2025082802271980000_14.7.e244122.10","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejcts.2007.12.020"},{"key":"2025082802271980000_14.7.e244122.11","doi-asserted-by":"crossref","first-page":"780","DOI":"10.1016\/S0016-5107(99)70301-9","article-title":"Case of Boerhaave's syndrome successfully treated with a self-expandable metallic stent","volume":"49","author":"Eubanks","year":"1999","journal-title":"Gastrointest Endosc"},{"key":"2025082802271980000_14.7.e244122.12","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1159\/000369967","article-title":"Successful treatment of septic shock due to spontaneous esophageal perforation 96 hours after onset by drainage and enteral nutrition","volume":"8","author":"Yamashita","year":"2014","journal-title":"Case Rep Gastroenterol"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2021-244122","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T09:27:30Z","timestamp":1756373250000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2021-244122"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,7]]},"references-count":12,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2021,7,13]]},"published-print":{"date-parts":[[2021,7]]}},"alternative-id":["10.1136\/bcr-2021-244122"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2021-244122","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,7]]}}}