Boerhaave syndrome history and symptoms: Difference between revisions
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==Overview== | ==Overview== | ||
The clinical manifestations of Boerhaave syndrome depend on the location of the perforation. Boerhaave syndrome often presents with excruciating retrosternal chest pain due to an intrathoracic esophageal perforation. Boerhaave syndrome classically associated with a history of severe retching and vomiting, however, 25 to 45 percent of patients have no history of vomiting. | The clinical manifestations of Boerhaave syndrome depend on the location of the perforation. Boerhaave syndrome often presents with excruciating retrosternal chest pain due to an intrathoracic esophageal perforation. Boerhaave syndrome classically associated with a history of severe retching and vomiting, however, 25 to 45 percent of patients have no history of vomiting. | ||
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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 clinical manifestations of Boerhaave syndrome depend on the location of the perforation. Boerhaave syndrome often presents with excruciating retrosternal chest pain due to an intrathoracic esophageal perforation. Boerhaave syndrome classically associated with a history of severe retching and vomiting, however, 25 to 45 percent of patients have no history of vomiting.
History and Symptoms
The clinical manifestations of Boerhaave syndrome depend on the location of the perforation (cervical, intrathoracic, or intra-abdominal), the time since the injury occurred, the degree of leakage.
- Boerhaave syndrome often presents with excruciating retrosternal chest pain due to an intrathoracic esophageal perforation. Boerhaave syndrome classically associated with a history of severe retching and vomiting, however, 25 to 45 percent of patients have no history of vomiting.[1]
Soon after the perforation, patients can have odynophagia, dyspnea, fever, tachypnea, tachycardia, cyanosis, and hypotension on physical examination. A pleural effusion may also occur.[2]
- Patients with cervical perforations can present with neck pain, dysphagia or dysphonia.
- Patients with an intra-abdominal perforation have epigastric pain that may radiate to the shoulder causing physicians to confuse an esophageal perforation with a myocardial infarction. They may also have back pain or present with an acute abdomen.
Mackler's triad (chest pain, vomiting and subcutaneous emphysema) is only present in 14% of patients.[3]
It may also be audibly recognized as Hamman's sign.
References
- ↑ Wilson RF, Sarver EJ, Arbulu A, Sukhnandan R (1971). "Spontaneous perforation of the esophagus". Ann. Thorac. Surg. 12 (3): 291–6. PMID 5112482.
- ↑ McGovern M, Egerton MJ (1991). "Spontaneous perforation of the cervical oesophagus". Med. J. Aust. 154 (4): 277–8. PMID 1994204.
- ↑ Woo KM, Schneider JI (2009). "High-risk chief complaints I: chest pain--the big three". Emerg. Med. Clin. North Am. 27 (4): 685–712, x. doi:10.1016/j.emc.2009.07.007. PMID 19932401. Unknown parameter
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