Boerhaave syndrome pathophysiology: Difference between revisions
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{{CMG}} {{AE}} {{DM}} {{SHH}} | {{CMG}} {{AE}} {{DM}} {{SHH}} | ||
==Overview== | ==Overview== | ||
Boerhaave syndrome is a spontaneous longitudinal perforation of the esophagus due to a sudden rise in intraesophageal pressure combined with negative intrathoracic pressure. It is commonly associated with the consumption of excessive food and/or alcohol. | Boerhaave syndrome is a spontaneous longitudinal [[perforation]] of the [[esophagus]] due to a sudden rise in intraesophageal pressure combined with negative [[intrathoracic]] pressure. It is commonly associated with the consumption of excessive food and/or alcohol. | ||
==Pathophysiology== | ==Pathophysiology== | ||
The pathophysiology of BHS is as follows:<ref name="pmid2730190">{{cite journal |vauthors=Pate JW, Walker WA, Cole FH, Owen EW, Johnson WH |title=Spontaneous rupture of the esophagus: a 30-year experience |journal=Ann. Thorac. Surg. |volume=47 |issue=5 |pages=689–92 |year=1989 |pmid=2730190 |doi= |url=}}</ref><ref name="pmid17263979">{{cite journal |author=Korn O, Oñate JC, López R |title=Anatomy of the Boerhaave syndrome |journal=Surgery |volume=141 |issue=2 |pages=222–8 |year=2007 |pmid=17263979 |doi=10.1016/j.surg.2006.06.034}}</ref><ref name="pmid15773835">{{cite journal |vauthors=Herbella FA, Matone J, Del Grande JC |title=Eponyms in esophageal surgery, part 2 |journal=Dis. Esophagus |volume=18 |issue=1 |pages=4–16 |year=2005 |pmid=15773835 |doi=10.1111/j.1442-2050.2005.00447.x |url=}}</ref><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 | The [[pathophysiology]] of BHS is as follows:<ref name="pmid2730190">{{cite journal |vauthors=Pate JW, Walker WA, Cole FH, Owen EW, Johnson WH |title=Spontaneous rupture of the esophagus: a 30-year experience |journal=Ann. Thorac. Surg. |volume=47 |issue=5 |pages=689–92 |year=1989 |pmid=2730190 |doi= |url=}}</ref><ref name="pmid17263979">{{cite journal |author=Korn O, Oñate JC, López R |title=Anatomy of the Boerhaave syndrome |journal=Surgery |volume=141 |issue=2 |pages=222–8 |year=2007 |pmid=17263979 |doi=10.1016/j.surg.2006.06.034}}</ref><ref name="pmid15773835">{{cite journal |vauthors=Herbella FA, Matone J, Del Grande JC |title=Eponyms in esophageal surgery, part 2 |journal=Dis. Esophagus |volume=18 |issue=1 |pages=4–16 |year=2005 |pmid=15773835 |doi=10.1111/j.1442-2050.2005.00447.x |url=}}</ref><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><ref name="pmid17669791">{{cite journal |vauthors=Saha A, Jarvis M, Thorpe JA, O'Regan DJ |title=Atypical presentation of Boerhaave's syndrome as Enterococcal bacterial pericardial effusion |journal=Interact Cardiovasc Thorac Surg |volume=6 |issue=1 |pages=130–2 |year=2007 |pmid=17669791 |doi=10.1510/icvts.2006.139667 |url=}}</ref><ref name="pmid1994204">{{cite journal |vauthors=McGovern M, Egerton MJ |title=Spontaneous perforation of the cervical oesophagus |journal=Med. J. Aust. |volume=154 |issue=4 |pages=277–8 |year=1991 |pmid=1994204 |doi= |url=}}</ref> | ||
* Boerhaave syndrome is a spontaneous perforation of the esophagus due to a sudden rise in intraesophageal pressure combined with negative intrathoracic pressure | * Boerhaave syndrome is a spontaneous [[perforation]] of the [[esophagus]] due to a sudden rise in intraesophageal pressure combined with negative [[Thoracic cavity|intrathoracic]] pressure | ||
** '''Severe straining''' | |||
** '''Vomiting''' | |||
** '''Seizures''' | |||
* As a result of [[neuromuscular]] [[incoordination]] resulting in a longitudinal [[esophageal perforation]]. | |||
* Boerhaave syndrome is commonly associated with the consumption of excessive food and/or alcohol. | * Boerhaave syndrome is commonly associated with the consumption of excessive food and/or alcohol. | ||
* The most common anatomical location of the esophageal perforation in Boerhaave syndrome | * The most common anatomical location of the [[esophageal perforation]] in Boerhaave syndrome- '''left posterolateral wall of the distal intrathoracic esophagus''' | ||
* The [[distal]] third of the [[esophagus]] is inherently weaker than the rest of the [[esophagus]] and 2-3 cm before the stomach. | |||
* The [[esophageal perforation]] in BHS can also occur in the [[cervical]] or intra-[[abdominal]] [[esophagus]]. | |||
==References== | ==References== | ||
Revision as of 17:43, 6 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] Shaghayegh Habibi, M.D.[3]
Overview
Boerhaave syndrome is a spontaneous longitudinal perforation of the esophagus due to a sudden rise in intraesophageal pressure combined with negative intrathoracic pressure. It is commonly associated with the consumption of excessive food and/or alcohol.
Pathophysiology
The pathophysiology of BHS is as follows:[1][2][3][4][5][6]
- Boerhaave syndrome is a spontaneous perforation of the esophagus due to a sudden rise in intraesophageal pressure combined with negative intrathoracic pressure
- Severe straining
- Vomiting
- Seizures
- As a result of neuromuscular incoordination resulting in a longitudinal esophageal perforation.
- Boerhaave syndrome is commonly associated with the consumption of excessive food and/or alcohol.
- The most common anatomical location of the esophageal perforation in Boerhaave syndrome- left posterolateral wall of the distal intrathoracic esophagus
- The distal third of the esophagus is inherently weaker than the rest of the esophagus and 2-3 cm before the stomach.
- The esophageal perforation in BHS can also occur in the cervical or intra-abdominal esophagus.
References
- ↑ Pate JW, Walker WA, Cole FH, Owen EW, Johnson WH (1989). "Spontaneous rupture of the esophagus: a 30-year experience". Ann. Thorac. Surg. 47 (5): 689–92. PMID 2730190.
- ↑ Korn O, Oñate JC, López R (2007). "Anatomy of the Boerhaave syndrome". Surgery. 141 (2): 222–8. doi:10.1016/j.surg.2006.06.034. PMID 17263979.
- ↑ Herbella FA, Matone J, Del Grande JC (2005). "Eponyms in esophageal surgery, part 2". Dis. Esophagus. 18 (1): 4–16. doi:10.1111/j.1442-2050.2005.00447.x. PMID 15773835.
- ↑ 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.
- ↑ Saha A, Jarvis M, Thorpe JA, O'Regan DJ (2007). "Atypical presentation of Boerhaave's syndrome as Enterococcal bacterial pericardial effusion". Interact Cardiovasc Thorac Surg. 6 (1): 130–2. doi:10.1510/icvts.2006.139667. PMID 17669791.
- ↑ McGovern M, Egerton MJ (1991). "Spontaneous perforation of the cervical oesophagus". Med. J. Aust. 154 (4): 277–8. PMID 1994204.