[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-447367-105":59,"doc-detail-447367-en":131},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":124,"head_meta":126,"extra_data":128,"updated_unix":130},105,"en","endoscopic-treatment-of-boerhaave-syndrome-related-empyema","Endoscopic Treatment of Boerhaave Syndrome Related Empyema","","Empyema and Boerhaave syndrome are both life-threatening conditions. This case report describes a patient with Boerhaave syndrome complicated by left empyema and sepsis, controlled using adequate pleural drainage and timely endoscopic oesophageal repair. Vomiting followed by polymicrobial empyema with Candida involvement should raise suspicion even without classical Mackler's Triad. Intravenous and oral contrast-enhanced CT helps assess the thoracic space and detect oesophageal leak. Intravenous antibiotics and repair of the perforation improve outcomes, and endoscopic repair can be considered in selected, including delayed, presentations.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/endoscopic-treatment-of-boerhaave-syndrome-related-empyema/447367/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/endoscopic-treatment-of-boerhaave-syndrome-related-empyema/447367.png","ImageObject",300,407,{"name":92,"@type":93},"mieayamfan","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-30","2026-09-29",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",11,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"What key clinical history suggests Boerhaave syndrome in this case?","Question",{"text":113,"@type":114},"A preceding history of vomiting followed by polymicrobial empyema with Candida involvement suggested Boerhaave syndrome, even without classical Mackler's Triad.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"How was the oesophageal leak evaluated?",{"text":118,"@type":114},"Intravenous and oral contrast-enhanced computed tomography identified contrast extravasation into the left pleural space, supporting an oesophageal leak.",{"name":120,"@type":111,"acceptedAnswer":121},"Why was endoscopic repair chosen and what outcome did it support?",{"text":122,"@type":114},"Endoscopic oesophageal repair was used to treat the perforation, reduce chest drain output, and control sepsis. It was considered a viable alternative to surgery in selected patients, including delayed presentations.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},447367,1790764407,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":81,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":39,"preview_page_count":4},962090893677,"https://ap-avatar.wpscdn.com/davatar_3d24733baf745e90a7e4bdd5f77d97b2","Respirology Case Reports  \nCASE REPORT  OPEN ACCESS   \nEndoscopic Treatment of Boerhaave Syndrome Related Empyema  \nChristopher Chan1  | Yueming Liang1,2 | Tommy Wing Ho Yip1 | Hon Chi Yip3 | Ken Ka Pang Chan1,4   \n1Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China | 21st People's Hospital ofFoshan, Foshan, China | 3Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR,  \nChina | 4Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, New Territories, Hong Kong SAR, China Correspondence: Ken Ka Pang Chan ([chankapang@cuhk.edu.hk](chankapang@cuhk.edu.hk))  \nReceived: 24 October 2025 | Accepted: 26 November 2025  \nAssociate Editor: Efsun Gonca Uğur Chousein  \nKeywords: Boerhaave syndrome | empyema | endoscopy | pleural infection | sepsis  \nABSTRACT  \nEmpyema and Boerhaave syndrome are both life-threatening conditions. We present a patient who suffered from Boerhaave syndrome complicated by left empyema, who had sepsis controlled with adequate pleural drainage and timely endoscopic oesophageal repair. A preceding history of vomiting with the occurrence of polymicrobial empyema with Candida involvement should prompt the suspicion of Boerhaave syndrome, despite the absence of classical Mackler's Triad. Early recognition of these interlinked conditions is essential for facilitating prompt management. Intravenous and oral contrast-enhanced computed tomography is crucial in evaluating the thoracic space and identifying an oesophageal leak. Intravenous antibiotics and repair of the oesophageal perforation can help to control sepsis and improve clinical outcome. Endoscopic repair is a viable alternative to surgical repair in select patients and can be considered even in those with a delayed presentation.  \n1 | Introduction  \nBoerhaave syndrome is an uncommon condition associated with high rates of mortality and morbidity [1]. It can lead to complications such as mediastinitis, pleural effusion or empyema [2]. Endoscopic management of the oesophageal defect is a minimally-invasive modality for repairing the oesophageal defect. While considered best suited to patients without signs of systemic sepsis, or as salvage therapy for patients unfit for surgery, it may still benefit select patients with early signs of systemic complications [1]. We present a patient with Boerhaave syndrome complicated by empyema formation, successfully treated by endoscopic oesophageal repair.  \n2 | Case Report  \nA 66-year-old male, who was a non-smoker and chronic drinker, with a background of hypertension and dyslipidaemia, presented  \nwith a 1-week history of malaise and productive cough associated with left-sided pleuritic chest pain and fever. One week prior to hospital admission, the patient vomited some undigested food. Initial physical examination revealed a blood pressure of 138/97 mmHg, tachycardia at 121 beats per minute and reduced air entry over the left chest. The abdominal examination was unremarkable with no signs of peritonitis. Chest x-ray found a left hydropneumothorax with mediastinal shift (Figure 1a), anda chest drain was inserted (Figure 1b) . Blood tests showed a white cell count of 17.9 × 109/L (83% neutrophils) and C-reactive protein of 277.4 mg/L. Drainage of the hydropneumothorax was performed, yielding turbid brownish material, and resulting in the re-expansion of the left lung. The pleural fluid was exudative, with a lactate dehydrogenase level of 5866 U/L. Culture of the pleural fluid yielded a polymicrobial growth of Streptococcus viridans, Streptococcus anginosus, Acinetobacter baumannii complex, Rothia dentocariosa and Candida species. Intravenous ampicillin-sulbactam and micafungin were administered.  \nThis is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the orig","cbCaili36Tagt6Om","https://ap.wps.com/l/cbCaili36Tagt6Om","pdf",906253,"English","# Introduction\n# Case Report","[{\"question\":\"What key clinical history suggests Boerhaave syndrome in this case?\",\"answer\":\"A preceding history of vomiting followed by polymicrobial empyema with Candida involvement suggested Boerhaave syndrome, even without classical Mackler's Triad.\"},{\"question\":\"How was the oesophageal leak evaluated?\",\"answer\":\"Intravenous and oral contrast-enhanced computed tomography identified contrast extravasation into the left pleural space, supporting an oesophageal leak.\"},{\"question\":\"Why was endoscopic repair chosen and what outcome did it support?\",\"answer\":\"Endoscopic oesophageal repair was used to treat the perforation, reduce chest drain output, and control sepsis. It was considered a viable alternative to surgery in selected patients, including delayed presentations.\"}]","Endoscopic Treatment of Boerhaave Syndrome Related Empyema | PDF",1790719940]