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Boerhaave's Syndrome

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Topic updated on 04/21/14 5:24pm

Snap Shot
  • A 18 year old girl presents with severe retrosternal chest pain that is aggravated by swallowing and deep breathing.
Introduction
  • Characterized by a full thickness rupture of the distal esophagus.
  • Associated with
    • repeated, forceful vomiting
      • e.g. Bulimia
    • esophageal perforations occur during endoscopic examinations
  • May result in pneumomediastinum
    • disection of air into anterior mediastinum
Presentation
  • Symptoms
    • retrosternal pain
    • bloody emesis
  • Physical exam
    • Hamman's crunch on chest ascultation
      • due to air in mediastinum
Evaluation
  • Chest CT
    • a left sided hydropneumothorax
    • pneumomediastinum
    • esophageal thickening
 


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