Doctors at Gleneagles Hospital Mumbai successfully treated a 70-year-old woman with a rare and life-threatening rupture of the food pipe caused by forceful vomiting. Instead of performing major surgery, the multidisciplinary team used advanced endoscopic vacuum therapy (EVT) followed by autologous fat grafting to close the tear and help her recover.
Led by Dr. Shankar Zanwar, Senior Consultant Gastroenterologist, along with Dr. Raj Kishore Agarwal, Internal Medicine Expert, the team managed the complex case through a minimally invasive approach. The patient recovered after multiple treatment sessions over several weeks and was discharged in stable condition.
Severe Symptoms Led to Timely Diagnosis
Mrs. Manjula Shah, a resident of Parel, Mumbai, had been healthy until she experienced severe vomiting followed by persistent difficulty in eating for nearly two months. Although her family initially tried home remedies, her condition worsened. She developed severe chest pain, increasing difficulty swallowing, and breathlessness before being admitted to Gleneagles Hospital.
Investigations revealed a large perforation in the lower esophagus, allowing food and infected material to leak into the chest cavity, causing a serious infection.
Minimally Invasive Treatment Instead of Surgery
Dr. Shankar Zanwar said, “Large tears in the food pipe are rare but can become life-threatening because food particles, saliva, and infected material leak into the chest cavity, leading to severe infection and complications. Our multidisciplinary team, comprising gastroenterologists, physicians, intensivists, anesthetists, and plastic surgeons, carefully evaluated the patient before deciding on the best treatment.”
He added that although surgery is usually the standard treatment, the team chose a less invasive option because of the patient’s condition and the existing infection. Early diagnosis and timely intervention played a crucial role in preventing further complications.
Advanced Endoscopic Vacuum Therapy Promoted Healing
The team performed Endoscopic Vacuum Therapy (EVT), in which doctors placed a specially designed vacuum-enabled tube endoscopically at the site of the tear. The device continuously removed infected fluid while promoting healthy tissue growth. Doctors replaced the vacuum system every three to four days, and the patient underwent five to six treatment sessions over several weeks.
As per the hospital’s press release, the treatment significantly reduced the cavity and shrank the defect. However, a small residual opening remained.
Fat Grafting Completed the Recovery
To close the remaining defect, doctors harvested a small amount of fat from the patient’s thigh, processed it through centrifugation, and injected it into the affected area. Using the patient’s own tissue promoted healing while minimizing the risk of rejection or complications.
“The defect closed completely, eliminating the need for major surgery,” Dr. Zanwar said. “Without timely intervention, the patient could have developed severe infection, sepsis, respiratory complications, or even died. This case highlights how advanced endoscopic techniques and multidisciplinary expertise can successfully manage highly complex gastrointestinal emergencies.”
Family Expresses Gratitude
The patient’s son, CA Bhavesh Shah, said the family was shocked to learn that severe vomiting had resulted in a rare condition known as Boerhaave syndrome. He recalled that eating, drinking, and even breathing had become difficult, and the family was anxious about the possibility of major surgery.
“The doctors explained every step of the treatment and supported us throughout the journey. We are grateful to the doctors, nurses, and hospital staff for helping my mother recover. Today, she is able to eat comfortably and return to her normal life,” he said.
Focus on Innovation and Teamwork
Dr. Bipin Chevale, CEO, Gleneagles Hospital Mumbai, said, “This case demonstrates the importance of advanced medical innovation and collaborative care in managing highly complex conditions. We are delighted to see the patient recover well and regain her quality of life.”
Image: Press release