Last month, when Airoli resident, Ashish Gandhi (name changed), suffered severe chest pain, he thought he was having a heart attack.
After a night of partying where he consumed alcohol, the businessman started vomiting profusely in the morning. Gandhi, 42, developed severe chest pain and his family members rushed him to Fortis Hiranandani Hospital in Vashi.
"Gandhi was first referred to a cardiologist. They conducted the electrocardiogram (ECG) test and a few blood tests. The tests were all negative," said Dr Shishir Shetty, thoracic surgeon who examined Gandhi in the Intensive Care Unit of the hospital on October 30.
A CT scan revealed that food particles had "leaked" into the chest cavity. "We then put a pipe in his chest and food particles came out," explained Dr Shetty.
When Dr Shetty explored Gandhi's chest area surgically he realised that his oesophagus or the food pipe had ruptured during the vomiting fit. "The pressure of vomiting resulted in the tear in his oesophagus," said Shetty.
Rupturing of the oesophagus is called Boerhaave Syndrome or spontaneous oesophagul rupture. This results in food particles entering the chest wall causing infection. If the intervention is delayed longer than 24 hours, the mortality rate in such cases is more 50%.
"Such cases have to be operated upon in the first 24 hours or else it can be fatal. The infection spreads fast and increases the mortality rate," said Dr Shetty.
Dr Shetty sutured the tear in the oesophagus and put Gandhi on a course of intravenous antibiotics. He was discharged from the hospital last week.
"While the condition is associated with any kind of vomiting, this normally occurs in cases of excessive drinking. In this case, the patient was not even a regular drinker," said Dr Shetty.
While the condition is known, the occurrence of such cases is rare. "We have handled such cases in the past. But they are rare to come by. We handle maybe
one or two cases in a year," said Dr Manmohan Kamat, a gastrointestinal surgeon.