Boerhaave syndrome
The chest pain is the constant element of this disease, which is progressive and generally not relieved by pain killers - Christelle Margot
image by: Patrick Cheah
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Boerhaave syndrome
The classic ‘‘Mackler’s triad’’ of esophageal rupture—chest pain, vomiting, and subcutaneous emphysema—has been estimated to occur in only 14-25% of cases. Up to two-thirds of patients may demonstrate subcutaneous emphysema on physical examination, whereas Hamman’s sign (a crunching sound synchronous with each heart beat) is rare. Other nonspecific signs include tachypnea and tachycardia, with 82% of patients meeting systemic inflammatory response syndrome criteria
Resources
Boerhaave's Syndrome: Still a Diagnostic and Therapeutic Challenge in the 21st Century
Diagnosis is challenging as the classic triad of vomiting, abdominal or chest pain, and subcutaneous emphysema is absent in many patients.
Esophageal Perforation: Pearls and Pitfalls for the Resuscitation Room
Esophageal perforation is a rare but frequently life-threatening condition that requires consideration in the appropriate clinical context in order to diagnose upon initial presentation.1-2 While the etiologies of this pathology are vast, by far most common is an iatrogenic cause, often secondary to endoscopic procedures.
Critical Cases - Boerhaave's Syndrome Emergency!
Presents with sudden onset severe, unrelenting, sharp retrosternal chest pain and hemodynamic instability, including hypotension, tachycardia, and tachypnea rapidly leading to shock
Atypical chest pain: A case report of Boerhaave syndrome
The spontaneous rupture of the esophagus, commonly called Boerhaave syndrome, is a rare and serious disease with poor prognosis due to its diagnostic difficulty. The patients suffering from this condition need multidisciplinary technical platform, and the survival of patients correlates highly with early medical care with fluid resuscitation, antibiotics administration, and surgical care to treat the perforation using endoscopy or extrathoracic surgery.
Boerhaave Syndrome- A Horrifying Rupture!
One of the better videos...
Boerhaave Syndrome: Hamman’s Crunch
Boerhaave syndrome classically presents in a male, middle aged alcoholic, with a history of recent alcohol consumption, presenting with the acute onset of excruciating chest pain, radiating to the back, with emesis. But up to 1/3 of patients have no history of vomiting. In the modern era, esophageal perforation most commonly occurs following upper G.I. endoscopy.
Boerhaave's syndrome: a review of management and outcome
It is uncommon for patients to present with the classic triad of retching, sudden epigastric pain and shock, hence causing delayed diagnosis. However, the outcome relies heavily on prompt diagnosis and treatment.
Boerhaave’s Syndrome: A Case Report
Boerhaave’s syndrome is a rare, life-threatening, spontaneous perforation of the esophagus, requiring urgent diagnosis and treatment. It was described for the first time by Herman Boerhaave in 1729. It is associated with high morbidity and mortality. The majority of Boerhaave’s syndrome occurs in individuals with a normal underlying esophagus; in some cases, eosinophilic esophagitis, medication-induced esophagitis, Barrett’s esophagus, or infectious ulcers can be observed.
Boerhaave’s syndrome: a pain in the neck
Boerhaave’s syndrome, or post-emetic rupture of the oesophagus, classically presents with vomiting, chest pain and subcutaneous emphysema. Mortality in this condition is very high and increases dramatically with delayed diagnosis and intervention. The vast majority of patients have a tear in the left posterior-lateral wall of the lower third of the oesophagus and require urgent surgical intervention.
Use of Bedside Ultrasound in Diagnosing Boerhaave Syndrome
Esophageal rupture is a rare condition that is recognized as one of the most fatal gastrointestinal injuries.
Boerhaave syndrome
1724 – Baron Jan von Wassenaer, the Grand Admiral of the Dutch Fleet and Prefect of Rhineland, ingested an emetic after eating a large meal. The forceful vomiting was associated with a tearing pain in the chest and the Baron died 24 hours later. The Baron’s demise was described in minute detail by Dutch physician Herman Boerhaave as a rupture of the esophagus with the exit of the gastric content into the mediastinum
StatPearls
Boerhaave syndrome is also known as spontaneous esophageal rupture or effort rupture of the esophagus. Although vomiting is thought to be the most common cause, other causes include those that can increase intra-esophageal pressure and cause a barogenic esophageal rupture.
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