Boerhaave's syndrome

Boerhaave's syndrome is a rare, life-threatening condition characterized by the spontaneous rupture of the esophagus, often associated with forceful or prolonged vomiting. It was first described by the Dutch physician Herman Boerhaave in the 18th century, hence its name.

Etiology

The primary cause of Boerhaave's syndrome is a sudden increase in intraesophageal pressure combined with negative intrathoracic pressure, typically caused by severe vomiting, retching, or coughing. Other factors that can contribute to the condition include alcoholism, bulimia, and certain surgical procedures.

Symptoms

The main symptoms of Boerhaave's syndrome include severe chest pain, vomiting, and shortness of breath. Other symptoms can include fever, tachycardia, and hypotension. The condition can lead to severe complications such as sepsis, mediastinitis, and multi-organ failure if not treated promptly.

Diagnosis

Diagnosis of Boerhaave's syndrome can be challenging due to its rarity and the non-specific nature of its symptoms. It is often misdiagnosed as myocardial infarction, pulmonary embolism, or spontaneous pneumothorax. Diagnostic tools that can aid in the diagnosis include chest X-ray, computed tomography (CT) scan, and esophagogastroduodenoscopy (EGD).

Treatment

The treatment of Boerhaave's syndrome is primarily surgical, with the aim of repairing the esophageal rupture. Non-surgical treatments such as antibiotics, intravenous fluids, and nutritional support are also important in managing the condition.

Prognosis

The prognosis of Boerhaave's syndrome is generally poor due to its high mortality rate, particularly if diagnosis and treatment are delayed. However, with prompt diagnosis and appropriate treatment, the prognosis can be significantly improved.

See also

• Esophagus
• Herman Boerhaave
• Esophageal rupture
• Mediastinitis