Doctors at Nanavati Max Super Speciality Hospital, Mumbai, successfully saved the life of a 75-year-old cancer survivor whose food pipe ruptured following a severe bout of retching (forceful vomiting). The medical team performed a minimally invasive endoscopic repair, avoiding the need for major open surgery.
A Rare and Life-Threatening Emergency
As per the press release, the patient had been visiting multiple hospitals for 15 days while battling fever, breathlessness, and fluid accumulation around the lungs. Despite treatment for pneumonia, his condition worsened.
When he was brought to Nanavati Max Hospital’s Emergency Department, doctors suspected a rupture of the oesophagus caused by a sudden increase in pressure during retching. A chest scan confirmed a rare and life-threatening diagnosis — Boerhaave’s syndrome.
Deciding on a Minimally Invasive Approach
Dr. Harshad Limaye, Associate Director, Internal Medicine at Nanavati Max Hospital, explained,
“Boerhaave’s syndrome is a rupture of the oesophagus that follows retching. It is a surgical emergency with a very high mortality rate. If untreated, patients may need an open-chest oesophagectomy, which carries major risks. Considering the leakage of contaminated fluid, the risk of infection, and the patient’s history of stomach cancer, we opted for a minimally invasive approach.”
Endoscopic Repair Performed Successfully
Under the guidance of Dr. Gaurav Patil, Director – Gastroenterology & Flexible Endoscopic Surgery, the team performed a complex endoscopic procedure.
“We passed the endoscope into the lower oesophagus and found a linear tear wider than a fingertip,” Dr. Patil said. “Using specialised needles and non-absorbable sutures, we stitched the tear internally, completely endoscopically. Such procedures are challenging as gastric acid and saliva can make achieving a watertight closure very difficult.”
Rapid Recovery Without External Incisions
The results were almost immediate. The chest drainage stopped, infection markers dropped, and the patient was able to sip water the next day. Oral meals resumed within 48 hours, the chest tube was removed after one week, and he was discharged without a single external incision.
Importance of Early Diagnosis and Intervention
Dr. Patil also cautioned against intentional vomiting, adding,
“Forceful vomiting can cause life-threatening oesophageal tears if not diagnosed in time.”
He further highlighted that flexible endoscopic procedures are excellent alternatives to open surgery, especially for elderly or immunocompromised patients. Early diagnosis and a multidisciplinary approach involving gastroenterologists, intensivists, and infectious disease specialists can enable scar-less organ preservation and save lives without using a scalpel.