Management of Boerhaave's syndrome: report of three cases.

From 2000 to 2005, three patients with Boerhaave's syndrome were successfully managed in our Department. Two of them received the appropriate treatment belatedly, with primary closure and bolstering tissue wrap. One of them required further intervention with a cervical esophagostomy and exclusion of the perforated esophagus. The third patient with an esophageal perforation related disorder, was managed with surgical exploration and drainage alone. Primary suturing of the esophagus should be performed only in patients with an early perforation. In cases of prolonged delay between rupture and diagnosis, esophageal resection with cervical esophagostomy and gastrostomy is advocated as the safest therapy.