Boerhaave syndrome physical examination: Difference between revisions
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{{CMG}} {{AE}} {{DM}} | {{CMG}} {{AE}} {{DM}} | ||
==Overview== | ==Overview== | ||
The patient might be in moderate distress with epigastric pain and bleeding. Patients may experience [[Tachycardia]], weak pulse, hypotension, [[Diaphoresis]] and fever. | The patient might be in moderate distress with [[epigastric]] pain and bleeding. Patients may experience [[Tachycardia]], weak pulse, [[hypotension]], [[Diaphoresis]] and [[fever]]. | ||
==Physical examination== | ==Physical examination== | ||
* Physical examination is usually not helpful, particularly early in the course. | |||
* [[Subcutaneous emphysema]] ([[Crepitations|crepitation]]) is an important diagnostic finding but is not very sensitive, being present in only 9 of 34 patients (27 percent) in one series . | |||
* A [[pleural effusion]] may be occur and be associated with an [[Enterococcal Infection|Enterococcal]] bacterial [[pericardial effusion]]. | |||
=== '''Appearance of the Patient''' === | === '''Appearance of the Patient''' === | ||
The patient might be in moderate distress with epigastric pain and bleeding. | The patient might be in moderate distress with [[epigastric pain]] and bleeding. | ||
=== '''Vital Signs''' === | === '''Vital Signs''' === | ||
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=== Neck === | === Neck === | ||
* Low Jugular venous pressure | * '''Low [[Jugular venous pressure]]''' | ||
=== Lungs === | === Lungs === | ||
* | * [[Subcutaneous emphysema|'''Subcutaneous emphysema''']] | ||
* Pneumomediastinum may cause a crackling sound on chest auscultation, known as the Hamman crunch. | * [[Pneumomediastinum]] may cause a crackling sound on chest auscultation, known as the '''[[Hamman's sign|Hamman's crunch]]'''. | ||
=== Heart === | === Heart === | ||
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=== Abdomen === | === Abdomen === | ||
* | * '''Abdominal rigidity''' | ||
=== Back === | === Back === | ||
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=== Neuromuscular === | === Neuromuscular === | ||
* Normal | * Normal | ||
==References== | ==References== | ||
Revision as of 17:46, 5 February 2018
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Mohamed Diab, MD [2]
Overview
The patient might be in moderate distress with epigastric pain and bleeding. Patients may experience Tachycardia, weak pulse, hypotension, Diaphoresis and fever.
Physical examination
- Physical examination is usually not helpful, particularly early in the course.
- Subcutaneous emphysema (crepitation) is an important diagnostic finding but is not very sensitive, being present in only 9 of 34 patients (27 percent) in one series .
- A pleural effusion may be occur and be associated with an Enterococcal bacterial pericardial effusion.
Appearance of the Patient
The patient might be in moderate distress with epigastric pain and bleeding.
Vital Signs
- Tachycardia
- Weak pulse
- Hypotension
- Diaphoresis
- Fever
Skin
HEENT
- Normal
Neck
Lungs
- Subcutaneous emphysema
- Pneumomediastinum may cause a crackling sound on chest auscultation, known as the Hamman's crunch.
Heart
Abdomen
- Abdominal rigidity
Back
- Normal
Extremities
- Normal
Genitourinary
- Normal
Neuromuscular
- Normal