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Fig. 2 | Journal of Medical Case Reports

Fig. 2

From: Third time recurrent Boerhaave’s syndrome: a case report

Fig. 2

Second episode. To the left, a computed tomography-scan depicting a transverse section of the lower thorax with a large, contained perforation (arrow). Note that there is discrete evidence of mediastinal emphysema and a small pleural effusion on the right side, indicating that the perforation is not entirely walled off. To the right, an illustration of our strategy to ensure adequate drainage. An upper midline laparotomy was performed, and guided by the endoscope, which was advanced extraluminally, a Delbet drain was inserted through the esophageal hiatus and then fixed with precision under visual control by means of endoscopic forceps

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