UAE expat almost died after his food pipe ruptured

Sharjah - The condition is called Boerhaave Syndrome.

Indian expat Shajimon thought he was having a heart attack as he suddenly felt pain in his chest and couldn’t breathe properly. Doctors told him it wasn’t an attack — but his food pipe had ruptured, a condition that was as life-threatening.

Specialists at Zulekha Hospital in Sharjah found a large amount of pus in his left chest cavity, which spilled from his oesophagus, hinting that it had ruptured.

Thoracic surgeon Dr Khaldoon Abo Dakka immediately inserted a tube into his left chest cavity to re-expand the lung that had collapsed. He also took an additional sample of the dark hazy fluid for a culture test.

The doctor confirmed that the 47-year-old expat had suffered a spontaneous rupture of lower oesophagus, also known as the food pipe that connects the mouth to the stomach. This condition, he said, was called Boerhaave Syndrome, which could lead to death if medical attention was delayed.

Oesophageal ruptures are tears that penetrate the wall of the oesophagus. Such tears could be caused by surgical procedures, severe vomiting, or swallowing a large piece of food. Some ruptures could also occur spontaneously. And when it happens, food or fluids would leak into the chest and cause severe lung problems.

Common symptoms include difficulty in swallowing or vomiting; followed by severe chest pain; difficulty in breathing and speaking; neck and shoulder pain; increase in upper or lower back pain discomfort when lying down flat; rapid breathing and heart rate; fever; and, in rare cases, bloody vomit.

Shajimon had acute gastritis complicated by severe vomiting, which could have led to the oesophageal tear, gastroenterologist Dr Mouhammed Mounier said.

Dr Mounier supported Dr Dakka’s team in sealing the damaged area from inside. An upper endoscopy confirmed a 2cm tear in the lower part of the expat’s food pipe.

Calling it a life-threatening situation, Dr Dakka said: “As further investigation continued, we suspected an abnormal connection between his chest cavity and oesophagus due to a large output of pus from the chest drain, which is a dangerous situation. Signs of severe infection became prominent, so his antibiotics were increased as part of the ongoing treatment.”

The leakage was sealed with a covered metallic stent and then another procedure had to be done to thoroughly clean his chest cavity and remove all the deposits that had developed.

Both procedures were completed in a total of four and half hours. Shajimon completely recovered in about a month. After two weeks on IV feeding, one week on clear liquid diet, subsequently followed by a semi-solid diet, he is now back to his normal life, eating like how he used to. Chest tubes, as well as the stent placed in his oesophagus, have also been removed, Dr Dakka said.

saman@khaleejtimes.com

• Sharjah