Boerhaave syndrome natural history, complications and prognosis
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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]
Overview
- If Boerhaave syndrome left untreated, the mortality reaches 100%. Without adequate treatment, survival of Boerhaave's syndrome is in days.
- Most common complications of Boerhaave syndrome include neumomediastinum, Mediastinitis, Sepsis, Posterior mediastinal abscess.
- Boerhaave's syndrome has a high mortality rate (14-40%).
Natural History
Diagnosis of Boerhaave's syndrome can easily be missed or delayed, leading to complications like dehydration, mediastinitis, sepsis and shock. This is what accounts for the high mortality rate if appropriate treatment is not started on time. And if left untreated, the mortality reaches 100%. Without adequate treatment, survival of Boerhaave's syndrome is in days. [1][2]
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 nonspecific clinical signs contributes 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.