Boerhaave syndrome natural history, complications and prognosis: Difference between revisions
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{{CMG}}; {{AE}} {{SHH}}, {{Ajay}}, {{FT}} | {{CMG}}; {{AE}} {{SHH}}, {{Ajay}}, {{FT}} | ||
==Overview== | ==Overview== | ||
[[Boerhaave syndrome]] (BHS), if left untreated, mortality | [[Boerhaave syndrome]] (BHS), if left untreated, mortality will reach 100%. Survival of Boerhaave's syndrome is witin days. Most common complications of [[Boerhaave syndrome]] include [[Pneumomediastinum|pneumomediastinum]], [[mediastinitis]], [[sepsis]], [[posterior]] [[mediastinal]] [[abscess]]. [[Boerhaave's syndrome]] has a high [[mortality rate]] (14-40%). | ||
==Natural History== | ==Natural History== | ||
* The natural history of BHS is as follows:<ref name="pmid23661858">{{cite journal |vauthors=Tamatey MN, Sereboe LA, Tettey MM, Entsua-Mensah K, Gyan B |title=Boerhaave's syndrome: diagnosis and successful primary repair one month after the oesophageal perforation |journal=Ghana Med J |volume=47 |issue=1 |pages=53–5 |year=2013 |pmid=23661858 |pmc=3645189 |doi= |url=}}</ref><ref>{{eMedicine|article|171683|Boerhaave syndrome}}</ref> | * The natural history of BHS is as follows:<ref name="pmid23661858">{{cite journal |vauthors=Tamatey MN, Sereboe LA, Tettey MM, Entsua-Mensah K, Gyan B |title=Boerhaave's syndrome: diagnosis and successful primary repair one month after the oesophageal perforation |journal=Ghana Med J |volume=47 |issue=1 |pages=53–5 |year=2013 |pmid=23661858 |pmc=3645189 |doi= |url=}}</ref><ref>{{eMedicine|article|171683|Boerhaave syndrome}}</ref> | ||
* Diagnosis of Boerhaave's syndrome can easily be missed or delayed, leading to complications like [[dehydration]], [[mediastinitis]], [[sepsis]] and [[shock]]. | * Diagnosis of Boerhaave's syndrome can easily be missed or delayed, leading to complications like [[dehydration]], [[mediastinitis]], [[sepsis]] and [[shock]]. | ||
* This accounts for the high mortality rate. If appropriate treatment is not started on time and if left untreated, the [[mortality]] reaches 100%. | * This accounts for the high mortality rate. If appropriate treatment is not started on time and if left untreated, the [[mortality]] rate reaches 100%. | ||
* Without adequate treatment, survival of Boerhaave's syndrome is | * Without adequate treatment, survival of Boerhaave's syndrome is within days. | ||
==Complications== | ==Complications== | ||
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==Prognosis== | ==Prognosis== | ||
[[Boerhaave's syndrome]] has a high [[mortality rate]] (14-40%).The | [[Boerhaave's syndrome]] has a high [[mortality rate]] (14-40%).The non-specific clinical signs contribute to the poor outcome of Boerhaave syndrome. <ref name="pmid21359901">{{cite journal |vauthors=Haveman JW, Nieuwenhuijs VB, Kobold JP, van Dam GM, Plukker JT, Hofker HS |title=Adequate debridement and drainage of the mediastinum using open thoracotomy or video-assisted thoracoscopic surgery for Boerhaave's syndrome |journal=Surg Endosc |volume=25 |issue=8 |pages=2492–7 |year=2011 |pmid=21359901 |pmc=3142333 |doi=10.1007/s00464-011-1571-y |url=}}</ref><ref name="pmid29384279">{{cite journal |vauthors=Lu H, Carron PN, Godat S, Pittet R |title=[Boerhaave syndrome: update on physiopathology, diagnosis and early management] |language=French |journal=Rev Med Suisse |volume=14 |issue=592 |pages=299–303 |year=2018 |pmid=29384279 |doi= |url=}}</ref> | ||
==References== | ==References== | ||
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[[Category:Gastroenterology]] | [[Category:Gastroenterology]] | ||
[[Category:Surgery]] | [[Category:Surgery]] | ||
[[Category: | [[Category:Up-To-Date]] | ||
Latest revision as of 14:49, 15 February 2021
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Shaghayegh Habibi, M.D.[2], Ajay Gade MD[3]], Feham Tariq, MD [4]
Overview
Boerhaave syndrome (BHS), if left untreated, mortality will reach 100%. Survival of Boerhaave's syndrome is witin days. Most common complications of Boerhaave syndrome include pneumomediastinum, mediastinitis, sepsis, posterior mediastinal abscess. Boerhaave's syndrome has a high mortality rate (14-40%).
Natural History
- The natural history of BHS is as follows:[1][2]
- Diagnosis of Boerhaave's syndrome can easily be missed or delayed, leading to complications like dehydration, mediastinitis, sepsis and shock.
- This accounts for the high mortality rate. If appropriate treatment is not started on time and if left untreated, the mortality rate reaches 100%.
- Without adequate treatment, survival of Boerhaave's syndrome is within days.
Complications
Most common complications of Boerhaave syndrome include:[3][4]
- Pneumomediastinum (air in the mediastinum)
- Mediastinitis (inflammation of the mediastinum)
- Infection and sepsis (fever, hypotension, and altered level of consciousness)
- Posterior mediastinal abscess
Prognosis
Boerhaave's syndrome has a high mortality rate (14-40%).The non-specific clinical signs contribute to the poor outcome of Boerhaave syndrome. [5][6]
References
- ↑ Tamatey MN, Sereboe LA, Tettey MM, Entsua-Mensah K, Gyan B (2013). "Boerhaave's syndrome: diagnosis and successful primary repair one month after the oesophageal perforation". Ghana Med J. 47 (1): 53–5. PMC 3645189. PMID 23661858.
- ↑ Boerhaave syndrome at eMedicine
- ↑ Ahmad R, Ishlah W, Shaharudin MH, Sathananthar KS, Norie A (2008). "Posterior mediastinal abscess secondary to esophageal perforation following fish bone ingestion". Med. J. Malaysia. 63 (2): 162–3. PMID 18942310.
- ↑ Maurya VK, Sharma P, Ravikumar R, Bhatia M (2016). "Boerhaave's syndrome". Med J Armed Forces India. 72 (Suppl 1): S105–S107. doi:10.1016/j.mjafi.2015.12.004. PMC 5192176. PMID 28050085.
- ↑ Haveman JW, Nieuwenhuijs VB, Kobold JP, van Dam GM, Plukker JT, Hofker HS (2011). "Adequate debridement and drainage of the mediastinum using open thoracotomy or video-assisted thoracoscopic surgery for Boerhaave's syndrome". Surg Endosc. 25 (8): 2492–7. doi:10.1007/s00464-011-1571-y. PMC 3142333. PMID 21359901.
- ↑ Lu H, Carron PN, Godat S, Pittet R (2018). "[Boerhaave syndrome: update on physiopathology, diagnosis and early management]". Rev Med Suisse (in French). 14 (592): 299–303. PMID 29384279.