Boerhaave syndrome pathophysiology
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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.