{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T06:07:39Z","timestamp":1788934059072,"version":"build-2803163510"},"reference-count":21,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T00:00:00Z","timestamp":1788912000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:p>Spontaneous oesophageal rupture is a rare and life-threatening condition requiring urgent intervention. Management is particularly challenging when the rupture is accompanied by extensive transmural necrosis and severe thoracic contamination. We report a male patient in his late 30s who underwent emergency treatment approximately 11\u2005h after symptom onset and was found to have an 8-cm full-thickness oesophageal tear with extensive transmural necrosis. Given the severe mediastinal and thoracic contamination and marked friability of the oesophageal wall, primary repair was considered unsuitable. A staged surgical strategy was therefore adopted. Stage I involved resection\/exclusion of the damaged thoracic oesophagus with cervical oesophageal exteriorisation, gastrostomy for gastric drainage and decompression, and jejunostomy for enteral nutritional support. Stage II, performed 4 months later, consisted of gastrointestinal reconstruction using a retrosternal gastric conduit. During the 18-month follow-up, the patient resumed unrestricted oral intake and showed favourable nutritional and functional recovery. This case suggests that a staged surgical strategy may represent a feasible treatment option in carefully selected patients with severe Boerhaave syndrome when secure primary repair is precluded by extensive oesophageal necrosis and severe thoracic contamination.<\/jats:p>","DOI":"10.3389\/fmed.2026.1902558","type":"journal-article","created":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T05:58:45Z","timestamp":1788933525000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Case Report: Two-stage surgical management of spontaneous oesophageal rupture with extensive necrosis"],"prefix":"10.3389","volume":"13","author":[{"given":"Fu-Hui","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Thoracic Surgery, The Affiliated Hospital of Qingdao University","place":["Qingdao, 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