User:Mr. Ibrahem/Esophageal rupture
| Mr. Ibrahem/Esophageal rupture | |
|---|---|
| Other names | Boerhaave syndrome, esophageal injury |
 | |
| Axial CT image through the upper chest showing extraluminal air (pneumediastinum) surrounding the trachea and esophagus | |
| Specialty | Gastroenterology, general surgery |
| Symptoms | Chest pain, shortness of breath, fever, trouble swallowing[1] |
| Complications | Mediastinitis, sepsis[2][1] |
| Causes | Endoscopy, trauma, caustic ingestion, vomiting, seizures, abdominal trauma, compressed air injury, childbirth[3][4] |
| Risk factors | Esophagitis, alcoholism, eating in excess[3] |
| Diagnostic method | May be supported medical imaging or endoscopy[1] |
| Differential diagnosis | Aortic dissection, acute pancreatitis, heart attack, pneumothorax[3] |
| Treatment | Intravenous fluids, antibiotics, surgery[5] |
| Prognosis | High risk of death[3] |
| Frequency | Rare[2] |
Esophageal rupture, also known as Boerhaave syndrome, is a full thickness tear of the esophageal wall.[1] Symptoms generally include chest pain.[1] Other symptoms may include shortness of breath, fever, and trouble swallowing.[1] Complications can include mediastinitis and sepsis.[2][1]
Causes include endoscopy, trauma, caustic ingestion, vomiting, seizures, abdominal trauma, compressed air injury, and childbirth.[3][4] While in most cases the esophagus is previously normal, esophagitis and esophageal ulcers are risk factors.[3] Other risk factors include alcoholism and eating in excess.[3] Diagnosis may be supported by a chest X-ray, esophagogram, CT scan, or endoscopy.[1] A crackling sound may be heart in time with the heart beat.[5]
Treatment is with intravenous fluids, antibiotics such as piperacillin/tazobactam, and surgery when the lower esophagus is involved.[5] The risk of death is high and without treatment people may die within days.[3][5] Some injuries of the middle and upper esophagus may be managed without surgery.[4] Early diagnosis improves outcomes.[3]
Esophageal rupture is rare.[2] This condition was first documented by the 18th-century physician Herman Boerhaave, after whom it is named.[6][7] Some use the term "Boerhaave" only for those cases due to increased intra-esophageal pressure.[3] Mallory-Weiss syndrome is a much less severe condition in which only the mucosa tears.[6]
References[edit]
- ^ a b c d e f g h Bautz, B; Schneider, JI (May 2020). "High-Risk Chief Complaints I: Chest Pain-The Big Three (an Update)". Emergency medicine clinics of North America. 38 (2): 453–498. doi:10.1016/j.emc.2020.01.009. PMID 32336336.
- ^ a b c d Oguma, J; Ozawa, S (July 2015). "[Idiopathic and Iatrogenic Esophageal Rupture]". Kyobu geka. The Japanese journal of thoracic surgery. 68 (8): 701–5. PMID 26197919.
- ^ a b c d e f g h i j Turner, AR; Turner, SD (January 2021). "Boerhaave Syndrome". PMID 28613559.
{{cite journal}}: Cite journal requires|journal=(help) - ^ a b c Mubang, RN; Sigmon, DF; Stawicki, SP (January 2021). "Esophageal Trauma". PMID 29261892.
{{cite journal}}: Cite journal requires|journal=(help) - ^ a b c d "Esophageal Rupture - Gastrointestinal Disorders". Merck Manuals Professional Edition. Archived from the original on 3 May 2021. Retrieved 2 May 2021.
- ^ a b "Boerhaave's syndrome". www.whonamedit.com. Archived from the original on 16 January 2020. Retrieved 2 May 2021.
- ^ Boerhaave, Herman (1724). Atrocis, nec descripti prius, morbis historia: Secundum medicae artis leges conscripta [Bitter or the results were registered before the history of the disease. According to the written laws of medicine] (in Latin). Lugduni Batavorum; Ex officine Boutesteniana. OCLC 952706276.