Type your tag names separated by a space and hit enter

Boerhaave Syndrome

Boerhaave Syndrome is a topic covered in the 5-Minute Emergency Consult.

To view the entire topic, please or purchase a subscription.

Emergency Central is a collection of disease, drug, and test information including 5-Minute Emergency Medicine Consult, Davis’s Drug, McGraw-Hill Medical’s Diagnosaurus®, Pocket Guide to Diagnostic Tests, and MEDLINE Journals created for emergency medicine professionals. Explore these free sample topics:

Emergency Central

-- The first section of this topic is shown below --

Basics

Description

  • Spontaneous esophageal rupture from sudden combined increase in intra-abdominal pressure and negative intrathoracic pressure
    • Causes complete, full-thickness (transmural), longitudinal tear in esophagus
  • Esophagus has no serosal layer (which normally contains collagen and elastic fibers):
    • Results in weak structure vulnerable to perforation and mediastinal contamination
    • Esophageal wall is further weakened by conditions that damage mucosa (i.e., esophagitis is of various causes).
  • Majority of perforations occur at left posterolateral wall of the lower third esophagus.
  • Significant morbidity/mortality (most lethal GI tract perforation):
    • Owing to explosive nature of tear
    • Owing to almost immediate contamination of mediastinum with contents of esophagus
    • Overall mortality can approach 20%
    • Mortality can double if treatment is delayed >24 hr from rupture
    • Cervical rupture associated with the lowest mortality, followed by abdominal and thoracic rupture, respectively

Etiology

  • Associated with:
    • Forceful vomiting and retching (most common)
    • Heavy lifting
    • Seizures
    • Childbirth
    • Blunt trauma
    • Induced emesis
    • Caustic ingestions
    • Laughing
    • History of Barrett ulcer
    • History of HIV/AIDS
    • History of pill esophagitis
  • Common in middle-aged men
  • Medical procedures cause over 50% of all perforations.

Pediatric Considerations
  • Described in female neonates but rarely seen
  • Consider caustic ingestions

-- To view the remaining sections of this topic, please or purchase a subscription --

Citation

* When formatting your citation, note that all book, journal, and database titles should be italicized* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Boerhaave Syndrome ID - 307530 ED - Barkin,Adam Z, ED - Barkin,Roger M, ED - Hayden,Stephen R, ED - Rosen,Peter, ED - Schaider,Jeffrey J, ED - Shayne,Philip, ED - Wolfe,Richard E, BT - 5-Minute Emergency Consult UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307530/all/Boerhaave_Syndrome PB - Lippincott Williams & Wilkins ET - 5 DB - Emergency Central DP - Unbound Medicine ER -