Boerhaave syndrome diagnostic study of choice

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

Overview

Contrast Esophagram usually establishes the diagnosis of an esophageal perforation
- The location and
- Extent of perforation
The accuracy of the test depends on
- The size and location of the perforation
- The technique used for the study.
False-negative results occur in as many as 10 % of cases.
Gastrografin a water-soluble contrast is used for the esophagram procedure.
If the Gastrografin esophagram is inconclusive, a barium esophagram should be performed.
Gastrografin is preferred over the barium esophagram to prevent barium induced inflammatory response in mediastinal or pleural cavities, whereas barium esophagram is very efficient in picking the small perforations.
Barium esophagram can detect
- 60 percent of cervical perforations
- 90 percent of intrathoracic perforations.

Contrast Esophagram usually establishes the diagnosis of an esophageal perforation^[1]^[2]^[3]^[4]^[5]
- The location and
- Extent of perforation
The accuracy of the test depends on
- The size and location of the perforation
- The technique used for the study.
False-negative results occur in as many as 10 % of cases.
Gastrografin a water-soluble contrast is used for the esophagram procedure.
If the Gastrografin esophagram is inconclusive, a barium esophagram should be performed.
Gastrografin is preferred over the barium esophagram to prevent barium induced inflammatory response in mediastinal or pleural cavities, whereas barium esophagram is very efficient in picking the small perforations.
Barium esophagram can detect
- 60 percent of cervical perforations
- 90 percent of intrathoracic perforations.

↑ Bladergroen MR, Lowe JE, Postlethwait RW (1986). "Diagnosis and recommended management of esophageal perforation and rupture". Ann. Thorac. Surg. 42 (3): 235–9. PMID 3753071.
↑ Dodds WJ, Stewart ET, Vlymen WJ (1982). "Appropriate contrast media for evaluation of esophageal disruption". Radiology. 144 (2): 439–41. doi:10.1148/radiology.144.2.7089304. PMID 7089304.
↑ James AE, Montali RJ, Chaffee V, Strecker EP, Vessal K (1975). "Barium or gastrografin: which contrast media for diagnosis of esophageal tears?". Gastroenterology. 68 (5 Pt 1): 1103–13. PMID 1126592.
↑ Schwartz SS (1975). "Letter: Barium or gastrografin: which contrast media for diagnosis of esophageal tears?". Gastroenterology. 69 (6): 1377. PMID 1193339.
↑ Vessal K, Montali RJ, Larson SM, Chaffee V, James AE (1975). "Evaluation of barium and gastrografin as contrast media for the diagnosis of esophageal ruptures or perforations". Am J Roentgenol Radium Ther Nucl Med. 123 (2): 307–19. PMID 1115308.