Boerhaave syndrome CT: Difference between revisions
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{{CMG}} {{AE}} {{DM}} {{SHH}} | {{CMG}} {{AE}} {{DM}} {{SHH}} | ||
==Overview== | ==Overview== | ||
CT of the chest and | CT of the chest and the [[abdomen]] should be performed when a suspected [[esophageal perforation]] is difficult to locate on contrast [[esophagogram]], when contrast [[esophagogram]] can not be performed (e.g, uncooperative or unstable patients, patients with [[Intraperitoneal|free peritoneal air]], and patients with localized collections of fluid for surgical drainage). | ||
==CT== | ==CT== | ||
*CT of the chest and | *CT of the chest and the [[abdomen]] should be performed when a suspected [[esophageal perforation]] is difficult to locate on contrast [[esophagogram]], when contrast [[esophagogram]] can not be performed (e.g, uncooperative or unstable patients, patients with [[Intraperitoneal|free peritoneal air]], and patients with localized collections of fluid for surgical drainage). | ||
*There will be evidence of extravasation of food particles or bile from the [[Esophagus|esophageal lumen]] into the [[pleural space]] or [[mediastinum]].<ref name="pmid20226056">{{cite journal |vauthors=Malik UF, Young R, Pham HD, McCon A, Shen B, Landres R, Mahmoud A |title=Chronic presentation of Boerhaave's syndrome |journal=BMC Gastroenterol |volume=10 |issue= |pages=29 |year=2010 |pmid=20226056 |pmc=2847967 |doi=10.1186/1471-230X-10-29 |url=}}</ref> | |||
CT findings include:<ref name="pmid2225947">{{cite journal |vauthors=Backer CL, LoCicero J, Hartz RS, Donaldson JS, Shields T |title=Computed tomography in patients with esophageal perforation |journal=Chest |volume=98 |issue=5 |pages=1078–80 |year=1990 |pmid=2225947 |doi= |url=}}</ref><ref name="pmid16793233">{{cite journal |vauthors=de Lutio di Castelguidone E, Merola S, Pinto A, Raissaki M, Gagliardi N, Romano L |title=Esophageal injuries: spectrum of multidetector row CT findings |journal=Eur J Radiol |volume=59 |issue=3 |pages=344–8 |year=2006 |pmid=16793233 |doi=10.1016/j.ejrad.2006.04.027 |url=}}</ref><ref name="pmid23493470">{{cite journal |vauthors=Tonolini M, Bianco R |title=Spontaneous esophageal perforation (Boerhaave syndrome): Diagnosis with *CT-esophagography |journal=J Emerg Trauma Shock |volume=6 |issue=1 |pages=58–60 |year=2013 |pmid=23493470 |pmc=3589863 |doi=10.4103/0974-2700.106329 |url=}}</ref> | CT findings include:<ref name="pmid2225947">{{cite journal |vauthors=Backer CL, LoCicero J, Hartz RS, Donaldson JS, Shields T |title=Computed tomography in patients with esophageal perforation |journal=Chest |volume=98 |issue=5 |pages=1078–80 |year=1990 |pmid=2225947 |doi= |url=}}</ref><ref name="pmid16793233">{{cite journal |vauthors=de Lutio di Castelguidone E, Merola S, Pinto A, Raissaki M, Gagliardi N, Romano L |title=Esophageal injuries: spectrum of multidetector row CT findings |journal=Eur J Radiol |volume=59 |issue=3 |pages=344–8 |year=2006 |pmid=16793233 |doi=10.1016/j.ejrad.2006.04.027 |url=}}</ref><ref name="pmid23493470">{{cite journal |vauthors=Tonolini M, Bianco R |title=Spontaneous esophageal perforation (Boerhaave syndrome): Diagnosis with *CT-esophagography |journal=J Emerg Trauma Shock |volume=6 |issue=1 |pages=58–60 |year=2013 |pmid=23493470 |pmc=3589863 |doi=10.4103/0974-2700.106329 |url=}}</ref> | ||
* Esophageal wall edema and thickening | * Esophageal wall edema and thickening | ||
* | * Peri-esophageal fluid | ||
* Mediastinal widening | * [[Mediastinal widening]] | ||
* Air and fluid in the pleural spaces, retroperitoneum, or lesser sac | * Air and fluid in the [[Pleural space|pleural spaces]], [[retroperitoneum]], or [[lesser sac]] | ||
==References== | ==References== | ||
Latest revision as of 20:40, 26 February 2018
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Boerhaave syndrome CT On the Web |
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American Roentgen Ray Society Images of Boerhaave syndrome CT |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Mohamed Diab, MD [2] Shaghayegh Habibi, M.D.[3]
Overview
CT of the chest and the abdomen should be performed when a suspected esophageal perforation is difficult to locate on contrast esophagogram, when contrast esophagogram can not be performed (e.g, uncooperative or unstable patients, patients with free peritoneal air, and patients with localized collections of fluid for surgical drainage).
CT
- CT of the chest and the abdomen should be performed when a suspected esophageal perforation is difficult to locate on contrast esophagogram, when contrast esophagogram can not be performed (e.g, uncooperative or unstable patients, patients with free peritoneal air, and patients with localized collections of fluid for surgical drainage).
- There will be evidence of extravasation of food particles or bile from the esophageal lumen into the pleural space or mediastinum.[1]
- Esophageal wall edema and thickening
- Peri-esophageal fluid
- Mediastinal widening
- Air and fluid in the pleural spaces, retroperitoneum, or lesser sac
References
- ↑ Malik UF, Young R, Pham HD, McCon A, Shen B, Landres R, Mahmoud A (2010). "Chronic presentation of Boerhaave's syndrome". BMC Gastroenterol. 10: 29. doi:10.1186/1471-230X-10-29. PMC 2847967. PMID 20226056.
- ↑ Backer CL, LoCicero J, Hartz RS, Donaldson JS, Shields T (1990). "Computed tomography in patients with esophageal perforation". Chest. 98 (5): 1078–80. PMID 2225947.
- ↑ de Lutio di Castelguidone E, Merola S, Pinto A, Raissaki M, Gagliardi N, Romano L (2006). "Esophageal injuries: spectrum of multidetector row CT findings". Eur J Radiol. 59 (3): 344–8. doi:10.1016/j.ejrad.2006.04.027. PMID 16793233.
- ↑ Tonolini M, Bianco R (2013). "Spontaneous esophageal perforation (Boerhaave syndrome): Diagnosis with *CT-esophagography". J Emerg Trauma Shock. 6 (1): 58–60. doi:10.4103/0974-2700.106329. PMC 3589863. PMID 23493470.