Spontaniczna perforacja ściany żołądka przemieszczonego do klatki piersiowej jako nietypowa odmiana zespołu Boerhaavego
Spontaneous perforation of the gastric wall displaced into the thorax as an atypical variant of Boerhaave syndrome

Summary/Abstract: This article describes the case of a 67-year-old female patient who was admitted to the Department of General Surgery for gastrointestinal obstruction. Intraoperatively, an esophageal hiatal hernia was found. During drainage of the diaphragmatic hernia sac into the peritoneal cavity, a linear rupture was found on the posterior wall of the stomach. The stomach displacement into the thorax in patients with hiatal hernias creates anatomical conditions similar to those in a typical Boerhaave syndrome. Rupture of the gastrointestinal tube in the thorax with subsequent mediastinitis carries a high death risk of up to 40%. In this paper, we describe a spontaneous rupture of the posterior wall of the stomach displaced into the thorax. This case, one of the first descriptions in the literature on gastric rupture in the mediastinum, shows that the coexistence of extensive hiatal hernia, obesity, and gastric perforation with subsequent pneumonia is a very difficult clinical situation to treat.

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