Health corner

Boerhaave’s syndrome

Forty-nine year old German automobile engineer was on a business trip to General Motors,Talegaon,when he had a bout of vomiting and was seized by an attack of excruciating pain in the chest and collapsed. Esophageal rupture was suspected and a team of doctors comprising Dr. Gajanan Wagholikar and Dr Mahesh Thombare,surgeons and Dr. Ashish Pathak,anaesthesist performed an emergency surgery (thoracotomy) where the chest was opened. There was a large rent in the lower esophagus and around 2 litres of ingested food and drinks had accumulated in the chest,compressing the lungs. The tear in the esophagus was repaired and the contents drained. The patient had a stormy recovery with chest infection and rhythm disturbances of the heart which settled with medicines. Boerhaave’s syndrome (esophageal rupture following vomiting) is an extremely rare but well described entity. It is one of the most lethal perforations of the digestive system. It usually happens due to uncoordinated muscle contraction during vomiting. “The stomach contents are forced into the chest at a high pressure during vomiting which causes chemical damage as well as introduces the infection,” explained Dr Gajanan Wagholikar,senior consultant in gastro-intestinal surgery,Aditya Birla Hospital.

Surgery development

Large anatomical ceramic head in ‘small’ cups for hip replacement surgery is set to change the way hip replacement is carried out in India. For the first time in Pune,Sai Shree Hospital has successfully performed total hip replacement using the newly launched Delta Motion implant on a 26-year-old male. The patient,Mangesh (name changed),was suffering from Avascular Necrosis (deterioration of bone due to diminished blood supply) of both hips with protrusion of left hip. The pain and stiffness was so acute that he could not even stand and walk properly. Due to lack of mobility he was not in a position to perform his daily household activities and even going to toilet was a challenge until he opted to undertake the total hip replacement. “The large head ceramic on ceramic cup technology option that is available for small Indian anatomy (with small acetabulums) leads to higher range of motion and greater stability – ideally suited for the Indian patient with demands like sitting cross legged during ‘pooja’ and ‘namaaz’. There are fewer complications and longer-lasting results,” said Dr Neeraj Adkar.