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Boerhaave's Syndrome

  • The esophagus is the tubelike structure that carries food from the mouth to the stomach.  Boerhaave's syndrome occurs when the esophagus ruptures from forceful vomiting and/or retching, resulting in a tear or hole in the esophagus.

  • Nausea and vomiting
  • Upper back pain at chest level that worsens with swallowing or breathing
  • Sensation of difficulty taking in a deep breath

  • Stethoscope exam over the mediastinum may reveal crackles.
  • Lung exam may show absent breath sounds due to a Pneumothorax (collapsed lung).
  • Subcutaneous Emphysema may be palpable (felt) in the neck.
  • Chest X-Ray may show subcutaneous Emphysema in the neck (often overlooked), air in the mediastinum, and/or a Pneumothorax.
  • Gastrograffin (swallow) X-Rays confirm the diagnosis and the location.

  • Surgical repair of the esophageal rupture
  • Broad spectrum intravenous antibiotics to treat or prevent mediastinitis

  • Mediastinitis -- this is an infection in the area of the chest that contains esophagus, heart, and major blood vessels.  Infections in this area can be catastrophic.

  • Mallory-Weiss Syndrome
  • Intramural hematoma
  • Esophagitis
  • Esophageal ulcer
  • Esophageal Cancer


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