Boerhaave syndrome physical examination: Difference between revisions
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{{Boerhaave syndrome}} | {{Boerhaave syndrome}} | ||
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==Overview== | ==Overview== | ||
==Physical examination== | ==Physical examination== | ||
Revision as of 19:39, 11 January 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
Physical examination
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
- Low Jugular venous pressure
Lungs
- Normal/Subcutaneous emphysema
- Pneumomediastinum may cause a crackling sound on chest auscultation, known as the Hamman crunch.
Heart
Abdomen
- Normal/Abdominal rigidity
Back
- Normal
Extremities
- Normal
Genitourinary
- Normal
Neuromuscular
- Normal
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 detected. A case report described presentation with an Enterococcal bacterial pericardial effusion.