Boerhaave syndrome

Overview

A rare spontaneous rupture of the esophagus which can occur during violent vomiting or retching.

Symptoms

* Vomiting * Retching * Chest pain * Breathing difficulty * Blood in vomit * Vomiting blood * Shock * Subcutaneous emphysema * Tachycardia * Laceration of esophagus

Causes

* Upper gastrointestinal endoscopy * Nausea and vomiting * Oesophageal foreign body

Treatment

Untreated Boerhaave's syndrome is uniformly fatal. Its treatment includes immediate antibiotic therapy to prevent mediastinitis and sepsis, surgical repair of the perforation, and if there is significant fluid loss it should be replaced with IV fluid therapy since oral rehydration is, obviously, not possible. Even with early surgical intervention the risk of death is high