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][3][1][5][6]
- Boerhaave syndrome is a spontaneous perforation of the esophagus due to a sudden rise in intraesophageal pressure combined with negative intrathoracic pressure (eg, severe straining, vomiting or 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 is at the 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. However, the esophageal perforation in Boerhaave syndrome can also occur in the cervical or intra-abdominal esophagus.
References
- ↑ 1.0 1.1 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.
- ↑ 3.0 3.1 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.