Presentation
Case Presentation In this report, we present a unique case of Boerhaave's syndrome in a 53-year-old male patient. [bmcgastroenterol.biomedcentral.com]
Table 2 Major co-morbidities were not greater when diagnosis was delayed <24 h >24 h to presentation to presentation No major co-morbidities 7 7 Major co-morbidities 5 15 <24 h >24 h to presentation to presentation No major co-morbidities 7 7 Major [academic.oup.com]
Boerhaave's syndrome presenting as a right-sided pleural effusion. Ann Acad Med Singapore. 2003;32(3):415-7. 10 Fikfav V, Gaur P, Kim MP. Endoscopic management of Boerhaave's syndrome presenting with hematemesis. [scielo.br]
[…] delaying presentation and diagnosis for weeks to months after rupture References ↑ McGovern M, Egerton MJ (1991). [wikidoc.org]
All clinicians need to be aware of this lethal disease, its frequently unusual presentations and the importance of early diagnosis. [pmj.bmj.com]
Entire Body System
- Fever
Fever may be present or not. Auscultation occasionally reveals decreased breath sounds on the perforation side. [hindawi.com]
Signs of infection like fever and sweating. How painful is Boerhaave’s syndrome? The pain is severe — some say excruciating — and vaguely localized around the site of the rupture. [my.clevelandclinic.org]
Gastrointestinal
- Abdominal Pain
Boerhaave’s syndrome presenting with abdominal pain and right hydropneumothorax. Am J Emerg Med 1996;14:53-6. Radhika TS, Bedi MS, Raju PC, Nagarajan M, Rao KM, Muralidharan S. Boerhaave’s syndrome: a case report & literature review. [revistas.upb.edu.co]
Symptoms in all of them began with intense abdominal pain. One of the patients was awakened by the pain and it appeared after ingestion in 3 other patients. [revistagastroenterologiamexico.org]
Boerhaave’s syndrome presenting with abdominal pain and right hydropneumothorax. Am J Emerg Med. 1996;14:53–6. CAS Article Google Scholar 7. Janssens J, Valembois P. Spontaneous rupture of the esophagus (Boerhaave’s syndorome). [intjem.biomedcentral.com]
Boerhaave's syndrome presenting with abdominal pain and right hydropneumothorax. Am J Emerg Med. 1996 Jan. 14(1):53-6. [QxMD MEDLINE Link]. Janjua KJ. Boerhaave's syndrome. Postgrad Med J. 1997 May. 73(859):265-70. [QxMD MEDLINE Link]. [emedicine.medscape.com]
- Dysphagia
Most treatment options available for the relief or treatment of dysphagia can be performed endoscopically.but can also be caused by Various modalities are currently available for the relief of dysphagia caused by malignant esophageal stricturesThe options [slideshare.net]
CLINICAL CASE 2 An 82 year old female outpatient who had clinical symptoms of dysphagia when trying to swallow solid food and weight loss underwent upper endoscopy. It showed an upper esophageal lesion which compromised 50% of the passage. [scielo.org.co]
Case Presentation A 53-year-old Caucasian male with a history of heavy nonsteroidal anti-inflammatory drug (NSAID) usage and chronic alcohol abuse presented to the emergency room with a four-month history of dysphagia, 45-pound weight loss, coffee-ground [bmcgastroenterol.biomedcentral.com]
- Persistent Vomiting
It generally develops during or after persistent vomiting as a consequence of a sudden increase in intraluminal pressure in the esophagus. It is extremely rare in clinical practice. [scielo.br]
- Melena
Compared with Mallory-Weiss syndrome, Boerhaave syndrome is rarely manifested through hematemesis or other signs of gastrointestinal bleeding, including melena.11. Dellon ES, Shaheen NJ. [scielo.br]
- Black Stools
She was admitted presenting with vomiting of fresh blood, black stools, epigastric pain, suffocation and exhaustion. [scielo.br]
Cardiovascular
- Hypotension
Besides typical symptoms, atypical symptoms such as hypotension, tachycardia, tachypnea, feverishness and cyanosis may also be present.11. Dellon ES, Shaheen NJ. [scielo.br]
Workup
X-Ray
- Right Pleural Effusion
A new chest X-ray revealed a rapidly evolving right pleural effusion (Figure 3). Subsequently, the patient was intubated and mechanically ventilated. A chest tube was inserted in the right pleural space. A brown, foul-smelling fluid was evacuated. [hindawi.com]
Treatment
It is a rare but life-threatening condition that requires urgent diagnosis and treatment. [hindawi.com]
The current management of Boerhaave syndrome includes conservative, endoscopic and surgical treatments. [ejcrim.com]
Endoscopic treatment includes the use of clips, sutures and self-expanding metallic stents. [scielo.org.co]
The severity of illness was also quite varied, regardless of time interval between injury and treatment. [academic.oup.com]
The choice between surgery or conservative treatment depends on many factors. [revistagastroenterologiamexico.org]
Prognosis
The combined advancement of medical imaging and surgical techniques have greatly improved the prognosis of these patients especially in case of early treatment. Full article [mjemonline.com]
Outlook / Prognosis What is the prognosis for someone with Boerhaave’s syndrome? Early diagnosis and treatment is key to avoid the complications of infection, including death. [my.clevelandclinic.org]
Early diagnosis governs the appropriate repair and the vial prognosis. [orbi.uliege.be]
[…] and retroperitoneal spaces esophageal perforation from iatrogenic injury Mallory-Weiss tear: partial thickness tear epiphrenic diverticulum: mimicking pneumomediastinum esophageal or pulmonary malignancy causing esophagopleural fistula Treatment and prognosis [radiopaedia.org]
Microchapters Home Patient Information Overview Historical Perspective Classification Pathophysiology Causes Differentiating Boerhaave syndrome from other Diseases Epidemiology and Demographics Risk Factors Screening Natural History, Complications and Prognosis [wikidoc.org]
Etiology
The etiologies of both Boerhaave and Mallory–Weiss syndromes are similar, both result from abnormally elevated intraluminal cardio-esophageal pressure during vomiting. [intjem.biomedcentral.com]
Its etiology involves a sudden increase in the intraesophageal pressure. The classic clinical symptoms are vomiting, chest pain, and subcutaneous emphysema, known as Mackler's triad. [revistagastroenterologiamexico.org]
Etiology Boerhaave syndrome is a barogenic injury resulting from a sharp increase in the intraluminal pressure against a closed cricopharyngeus. [emedicine.medscape.com]
Epidemiology
Epidemiology, pathophysiology, diagnosis. Pol Przegl Chir 2016;88:359–364. Rokicki M, Rokicki W, Rydel M. Boerhaave's syndrome - over 290 yrs of surgical experiences. Surgical, endoscopic and conservative treatment. Pol Przegl Chir 2016;88:365–372. [ejcrim.com]
Jump to navigation Jump to search Boerhaave syndrome Microchapters Home Patient Information Overview Historical Perspective Classification Pathophysiology Causes Differentiating Boerhaave syndrome from other Diseases Epidemiology and Demographics Risk [wikidoc.org]
Epidemiology International data Although it is likely underreported, the incidence of Boerhaave syndrome is relatively rare, with an estimated incidence of 3.1 per 1,000,000 persons per year. [4] Among esophageal perforations, aproximately 15% are spontaneous [emedicine.medscape.com]
Pathophysiology
Epidemiology, pathophysiology, diagnosis. Pol Przegl Chir 2016;88:359–364. Rokicki M, Rokicki W, Rydel M. Boerhaave's syndrome - over 290 yrs of surgical experiences. Surgical, endoscopic and conservative treatment. Pol Przegl Chir 2016;88:365–372. [ejcrim.com]
Jump to navigation Jump to search Boerhaave syndrome Microchapters Home Patient Information Overview Historical Perspective Classification Pathophysiology Causes Differentiating Boerhaave syndrome from other Diseases Epidemiology and Demographics Risk [wikidoc.org]
Diagnostic considerations in mediastinal emphysema: a pathophysiologic-roentgenologic approach to Boerhaave's syndrome and spontaneous pneumomediastinum. Am J Roentgenol Radium Ther Nucl Med. 1972 Jul. 115(3):495-511. [QxMD MEDLINE Link]. [emedicine.medscape.com]
Regarding pathophysiology, Mallory–Weiss lacerations are caused by repeated retching and primarily involve the part of the gastric cardia that includes the EGJ. [intjem.biomedcentral.com]
The pathophysiology of Boerhaave syndrome involves a sudden rise in intraluminal esophageal pressure, thereby forcing the gastric contents against a tight cricopharyngeus muscle.33. Garas G, Zarogoulidis P, Efthymiou A, et al. [scielo.br]
Prevention
Secondary Prevention Cost-Effectiveness of Therapy Future or Investigational Therapies Case Studies Case #1 Boerhaave syndrome classification On the Web Most recent articles Most cited articles Review articles CME Programs Powerpoint slides Images American [wikidoc.org]
The increase in average life expectancy requires a case-by-case approach, where the benefits of invasive manoeuvres and likelihood of discharge are weighed against an acceptable quality of life, aiming to prevent futile medical treatment. [ejcrim.com]
Atypical symptoms may be prevented through timely diagnosis. Pneumomediastinum is a significant clinical finding.1010. Fikfav V, Gaur P, Kim MP. Endoscopic management of Boerhaave's syndrome presenting with hematemesis. [scielo.br]
The perforation probably occurred because the patient could not expel air from the first endoscopy as the edema produced by biopsies prevented adequate cricopharyngeal relaxation. [scielo.org.co]
The double-type Niti-S stent (Taewoong Medical)A fully covered inner nitinol stent prevents tumor ingrowth, and an outer uncovered nitinol sleeve in the mid-portion of the stent is meant to prevent migration, thus combining the best properties of both [slideshare.net]