75-Year-Old Patient Recovers After Life-Threatening Food Pipe Rupture at Nanavati Max Hospital

Mumbai: Doctors at Nanavati Max Super Speciality Hospital saved the life of a 75-year-old cancer survivor, whose food pipe ruptured due to retching (forceful vomiting), by performing a minimally invasive endoscopic repair of his torn food pipe.

The patient visited multiple hospitals for 15 days, in the hope of getting better treatment after battling fever, breathlessness, and being treated for pneumonia and fluid collection around the lungs.

He was then brought to Nanavati Max Hospital in the Emergency in a serious condition. The patient was experiencing breathlessness that began after an episode of retching. It was suspected that the patient had suffered an oesophageal rupture due to a sudden increase in pressure within the food pipe. A chest scan confirmed a rare diagnosis- Boerhaave’s syndrome.

Dr. Harshad Limaye, Associate Director, Internal Medicine, Nanavati Max Super Speciality Hospital, Mumbai, said, “Boerhaave’s syndrome is a rupture of the oesophagus, usually followed by retching. It is a life-threatening surgical emergency with a high mortality rate.

If left untreated, it may require an open‐chest oesophagectomy, which also carries significant risks. Given the leakage of contaminated fluid into the chest cavity, the high chances of infection, and the patient’s history of stomach cancer, the surgical team opted for a minimally invasive approach.”

A non-invasive endoscopic procedure was planned under the guidance of Dr. Gaurav Patil, Director – Gastroenterology & Flexible Endoscopic Surgery, Nanavati Max Super Speciality Hospital, Mumbai.

Speaking on the treatment, Dr. Patil said, “We passed the endoscope into the lower oesophagus, locating a linear tear wider than a fingertip. Using non-absorbable sutures and specialised needles, we created an intra-luminal stitch line to close the gap, all performed endoscopically (by inserting instruments into the mouth cavity).

Such procedures are rarely attempted as gastric acids and constant swallowing of saliva make a watertight closure notoriously difficult.”

The impact was immediate. Chest drainage stopped, infection markers fell, and the patient began sipping water the next day. Oral meals resumed within 48 hours, the chest tube was removed after one week, and the patient was discharged without a single external incision.

Dr. Patil further advised, “In this case, the patient’s retching was due to his illness, but some people intentionally induce vomiting. Forceful vomiting carries real risks; it can cause tears in the food pipe, which may be life-threatening if not diagnosed quickly.”

Flexible endoscopic procedures are an excellent alternative to open surgeries, especially for elderly or immunocompromised patients. In cases such as this one, early diagnosis and advanced interventions by a team of gastroenterologists, intensivists, and infectious disease specialists can achieve scarless organ preservation and save the patient’s life without a scalpel.