Boerhaave syndrome
You don't need to be Editor-In-Chief to add or edit content to WikiDoc. You can begin to add to or edit text on this WikiDoc page by clicking on the edit button at the top of this page. Next enter or edit the information that you would like to appear here. Once you are done editing, scroll down and click the Save page button at the bottom of the page.
| Boerhaave syndrome Classification and external resources | |
 | |
|---|---|
| ICD-10 | K22.3 |
| ICD-9 | 530.4 |
| DiseasesDB | 9168 |
| eMedicine | med/233 |
| MeSH | D004939 |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Phone:617-525-6884
Please Take Over This Page and Apply to be Editor-In-Chief for this topic: There can be one or more than one Editor-In-Chief. You may also apply to be an Associate Editor-In-Chief of one of the subtopics below. Please mail us [2] to indicate your interest in serving either as an Editor-In-Chief of the entire topic or as an Associate Editor-In-Chief for a subtopic. Please be sure to attach your CV and or biographical sketch.
Overview
Boerhaave syndrome (also called Boerhaave's syndrome), or Esophageal perforation, is rupture of the esophageal wall. It is most often caused by excessive vomiting in eating disorders such as bulimia although it may rarely occur in extremely forceful coughing or other situations, such as obstruction by food. It can cause pneumomediastinum and/or mediastinitis (air or inflammation of the mediastinum) and sepsis.
This condition was first documented by the 18th-century physician Herman Boerhaave, after whom it is named.[1][1]
Symptoms
It typically occurs after forceful vomiting. Boerhaave syndrome is a transmural perforation (full-thickness; a hole) of the esophagus, distinct from Mallory-Weiss syndrome, a nontransmural esophageal tear also associated with vomiting.
Because it is generally associated with vomiting, Boerhaave syndrome usually is not truly spontaneous. However, the term is useful for distinguishing it from iatrogenic perforation, which accounts for 85-90% of cases of esophageal rupture, typically as a complication of an endoscopic procedure, feeding tube, or unrelated surgery. Boerhaave syndrome is often seen as a complication of Bulimia.
It is associated with "Meckler's triad".[1][1]
Pathophysiology
Esophageal rupture in Boerhaave syndrome is thought to be the result of a sudden rise in internal esophageal pressure produced during vomiting, as a result of neuromuscular incoordination causing failure of the cricopharyngeus muscle (a sphincter within the esophagus) to relax. The syndrome is commonly associated with the consumption of excessive food and/or alcohol.
The most common anatomical location of the tear in Boerhaave syndrome is at left posterolateral wall of the lower third of the esophagus, 2-3 cm before the stomach.[1]
Diagnosis
Images shown below are courtesy of RadsWiki
 |
|
 |
Treatment
Its treatment includes immediate antibiotic therapy to prevent mediastinitis and sepsis, surgical repair of the perforation,[1] and if there is significant fluid loss it should be replaced with IV fluid therapy since oral rehydration is, obviously, not possible.
References
References
de:Boerhaave-Syndrom
| ||||
Acknowledgement and Attribution Regarding Sources of Content
Some of the initial content on this page may be incorporated in part from copyleft sources in the public domain including wikis such as Wikipedia and AskDrWiki. Drug information for patients came from the The National Library of Medicine. Infectious disease information may have come from the Centers for Disease Control (CDC). Differential Diagnoses are drawn from clinicians as well as an amalgamation of 3 sources: 1.The Disease Database; 2. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:3; 3. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:7 .
