Mumbai doctors save elderly woman from life-threatening food pipe rupture caused due to forceful vomiting

Mumbai doctors have successfully treated a 70yearold woman suffering from a rare and lifethreatening rupture of the food pipe caused by forceful vomitingThe 70yearold patient arrived at the hospital with severe chest pain difficulty swallowing and breathing problems Detailed evaluation revealed a big hole in her lower esophagus food pipe allowing food and infected material to leak into the chest cavity Considering the complexity of the condition and the associated infection the medical team opted for an advanced nonsurgical approach involving endoscopic vacuum therapy followed by autologous fat grafting After multiple treatment sessions and weeks of dedicated care the defect closed successfully allowing the patient to recover without undergoing major surgeryManjula Shah a resident of Parel Mumbai had been in good health until she experienced a severe episode of forceful vomiting and eating problem for two months The family tried home remedies but failed to provide her muchneeded relief Soon after she developed intense chest pain increasing difficulty in swallowing food and liquids and breathlessness She was admitted to Gleneagles Hospital After a gastroenterological evaluation because of swallowing difficulties further investigations revealed a large perforation in the lower part of her food pipe The condition was particularly concerning because leakage from the defect had already caused contamination and infection within the chest cavityA team led by Mumbaibased doctors Dr Shankar Zanwar Senior Consultant Gastroenterologist including Dr Raj Kishore Agarwal Internal Medicine Expert at the hospital came to the rescueDr Zanwar said ldquoDetailed evaluation showed a large defect in the lower oesophagus commonly known as the food pipe Such tears are rare but can become lifethreatening because food particles saliva and infected material can leak into the chest cavity leading to severe infections and complications She was admitted for specialised care and managed through a coordinated multidisciplinary approach involving gastroenterologists physicians intensivists anesthetists and plastic surgeonsIn most cases surgery is considered the standard treatment option However due to the infection already present and the patients overall condition we believed a less invasive approach would offer a safer pathway to recovery Early diagnosis and timely intervention played a critical role in preventing further deteriorationDr Zanwar continued ldquoWe decided to perform Endoscopic Vacuum Therapy EVT an advanced technique that helps promote healing During the procedure a specially designed vacuumenabled tube was placed endoscopically inside the food pipe at the site of the defect The tube continuously removed infected fluids and stimulated healthy tissue growth allowing the tear to gradually shrink The vacuum system had to be replaced every three to four days and the patient underwent nearly five to six treatment sessions over several weeks This treatment reduced the size of the cavity and shrank the hole that had formed in the lower esophagus However a small residual opening remained which required an additional innovative step to achieve complete closurerdquoDr Zanwar added ldquoTo close the remaining defect we harvested a small amount of the patients own fat tissue from her thigh The fat was carefully processed through centrifugation and then injected into the residual defect Using the patients own tissue helped enhance healing and tissue regeneration while reducing the risk of rejection or complications The defect subsequently closed completely eliminating the need for major surgery The patient was discharged after three to four weeks in a stable condition What made this case truly remarkable was the patients commitment to a prolonged treatment process Without timely intervention this condition could have resulted in severe infection sepsis respiratory complications and even death This case highlights how advanced endoscopic techniques combined with multidisciplinary expertise can successfully manage even highly complex gastrointestinal emergencies while avoiding major surgeryldquoEarly this year my mother was admitted to the hospital in a critical condition What initially seemed like severe vomiting and chest discomfort turned out to be a rare and lifethreatening oesophageal rupture or Boerhaave syndrome She also developed serious infections and complications We as a family were worried The entire experience was frightening because she had never imagined that vomiting could lead to such a serious condition Eating drinking and even breathing became difficult and we were worried about undergoing major surgery at this age The treatment required patience and multiple procedures but the doctors explained every step and gave us confidence throughout the journey We are thankful to the entire team of doctors nurses and hospital staff for their dedication care and support Today she is relieved to be able to eat comfortably and return to her normal life Our family will always remain grateful to Gleneagles Hospital and Dr Shankar for giving my mother a second chance at liferdquo said Shahs son Bhavesh Shah