Two Cases of Boerhaave's Syndrome Treated by Endoscopic Hemoclipping / 대한소화기내시경학회지

Boerhaave's syndrome is a spontaneous esophageal perforation due to severe nausea and vomiting after hyperphagia or drinking, and it is not due to trauma, medical instrumentation or a foreign body. Untreated esophageal perforation is associated with high mortality, and the traditional treatment has been surgical drainage and primary repair of the perforation. However, non-surgical primary repair with an endoscopic procedure has recently been attempted in some selected patients with a small sized perforation, limited contamination of the mediastinum and no evidence of sepsis. We report here on 2 patients with Boerhaave's syndrome and who were successfully treated via primary repair with endoscopic hemoclips, and we review the other cases of the Boerhaave's syndrome that were treated with a endoscopic procedure.

The Usefulness of Endoscopic Hemoclipping in the Management of Mallory - Weiss syndrome / 대한소화기내시경학회지

Mallory-Weiss syndrome is a laceration in the region of the gastroesophageal junction due to vomiting, retching, coughing preceding hematemesis in alcoholic patient. Bleeding from Mallory-Weiss tears stop spontaneously without specific therapy in 80-90 percent of patient, but rebleeding is uncommonly occurring in 2 to 5 percent of patients. Thus most patients require only supportive care. Rarely endoscopic therapy or operative therapy may be required. We conducted an uncontrolled study to evaluate an improved metallic clip(Olympus hemoclip) for the endoscopic treatment of Mallory-Weiss syndrome. Initial hemostasis was achieved in all patients with active bleeding. No complications resulted from this treatment. Clips did not impair healing of teared mucosa. We conclude that endoscopic hemoclip placement is a highly effective and safe method for treating uncontrolled Mallory-Weis syndrome.