| Boerhaave syndrome Classification and external resources |
|
| ICD-10 | K22.3 |
|---|---|
| ICD-9 | 530.4 |
| DiseasesDB | 9168 |
| MedlinePlus | 000231 |
| eMedicine | med/233 |
| MeSH | D004939 |
Boerhaave syndrome (also called Boerhaave's syndrome), or Esophageal perforation, is rupture of the esophageal wall. The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify Diseases The International Statistical Classification of Diseases and Related Health Problems 10th Revision ( ICD -10) is a coding of diseases and signs symptoms abnormal findings K00-K93 - Diseases of the digestive system (K00-K14 Diseases of oral cavity salivary glands and jaws ( Disorders of Tooth development and Eruption The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify Diseases The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. The Diseases Database is a free Website that provides information about the relationships between medical conditions Symptoms, and Medications. MedlinePlus, with the MedlinePlus Medical Encyclopedia, is a website network containing Health information from the world's largest medical Library eMedicine is an online clinical medical knowledge base that was founded in 1996 by Scott Plantz and Richard Lavely two medical doctors Medical Subject Headings ( MeSH) is a huge Controlled vocabulary (or metadata system for the purpose of indexing journal articles and books The esophagus or oesophagus (see American and British English spelling differences) sometimes known as the gullet, is an organ in It is most often caused by excessive vomiting in eating disorders such as bulimia although it may rarely occur in extremely forceful coughing or other situations, such as obstruction by food. Vomiting (also called throwing up, emesis) is the forceful expulsion of the contents of one's Stomach through the Mouth and sometimes the An eating disorder is a compulsion to eat or avoid eating that negatively affects both one's physical and mental health Bulimia nervosa is an Eating disorder characterized by recurrent Binge eating, followed by compensatory behaviors referred to as "purging" In Medicine, a cough ( Latin: tussis) is a sudden and often repetitively occurring defence Reflex which helps to clear the large breathing passages An esophageal food bolus obstruction (or steakhouse syndrome) is a medical emergency caused by the obstruction of the Esophagus by an ingested Foreign It can cause pneumomediastinum and/or mediastinitis (air or inflammation of the mediastinum) and sepsis. Pneumomediastinum (from Greek pneuma - "air" also known as mediastinal emphysema) is a condition in which air is present in the Mediastinum Mediastinitis is Inflammation of the tissues in the mid-chest or Mediastinum. The mediastinum is a non-delineated group of structures in the Thorax (chest surrounded by Loose connective tissue. Sepsis is a serious medical condition characterized by a whole-body inflammatory state (called a Systemic inflammatory response syndrome or SIRS caused
This condition was first documented by the 18th-century physician Herman Boerhaave, after whom it is named. Herman Boerhaave ( Voorhout, December 31, 1668 - Leiden, September 23, 1738) was a Dutch botanist humanist [1][2]
Contents |
Symptoms
It typically occurs after forceful vomiting. Vomiting (also called throwing up, emesis) is the forceful expulsion of the contents of one's Stomach through the Mouth and sometimes the Boerhaave syndrome is a transmural perforation (full-thickness; a hole) of the esophagus, distinct from Mallory-Weiss syndrome, a nontransmural esophageal tear also associated with vomiting. The esophagus or oesophagus (see American and British English spelling differences) sometimes known as the gullet, is an organ in Mallory-Weiss syndrome refers to bleeding from tears (a Mallory-Weiss tear) in the Mucosa at the junction of the Stomach and Esophagus, usually Because it is generally associated with vomiting, Boerhaave syndrome usually is not truly spontaneous. However, the term is useful for distinguishing it from iatrogenic perforation, which accounts for 85-90% of cases of esophageal rupture, typically as a complication of an endoscopic procedure, feeding tube, or unrelated surgery. The terms iatrogenesis and iatrogenic artifact refer to adverse effects or complications caused by or resulting from medical treatment or advice Endoscopy means looking inside and typically refers to looking inside the body for medical reasons using an instrument called an endoscope. Surgery (from the χειρουργική cheirourgikē, via chirurgiae meaning "hand work" is a medical specialty that uses operative manual and instrumental Boerhaave syndrome is often seen as a complication of Bulimia.
It is associated with "Mackler's triad". [3][4]
Pathophysiology
Esophageal rupture in Boerhaave syndrome is thought to be the result of a sudden rise in internal esophageal pressure produced during vomiting, as a result of neuromuscular incoordination causing failure of the cricopharyngeus muscle (a sphincter within the esophagus) to relax. A sphincter is a structure usually a circular Muscle, that normally maintains constriction of a natural body passage or orifice and which relaxes as required by normal physiological The syndrome is commonly associated with the consumption of excessive food and/or alcohol.
The most common anatomical location of the tear in Boerhaave syndrome is at left posterolateral wall of the lower third of the esophagus, 2-3 cm before the stomach. In Human anatomy, the stomach is a J-shaped hollow muscular organ of the Gastrointestinal tract involved in the second phase of Digestion, following [5]
Treatment
Untreated Boerhaave's syndrome is uniformly fatal. Its treatment includes immediate antibiotic therapy to prevent mediastinitis and sepsis, surgical repair of the perforation,[6] and if there is significant fluid loss it should be replaced with IV fluid therapy since oral rehydration is, obviously, not possible. In modern usage an antibiotic is a Chemotherapeutic agent with activity against Microorganisms such as Bacteria, fungi or Protozoa Mediastinitis is Inflammation of the tissues in the mid-chest or Mediastinum. Intravenous therapy or IV therapy is the giving of Liquid substances directly into a Vein. Even with early surgical intervention the risk of death is high.
Notes
- ^ synd/2800 at Who Named It
- ^ H. Who Named It? is an English-language dictionary of medical eponyms and the People associated with their identification Boerhaave. Atrocis, nec descripti prius, morbis historia: Secundum medicae artis leges conscripta. Lugduni Batavorum; Ex officine Boutesteniana. 1724.
- ^ S. Herman, H. Shanies, H. Singh & M. Warshawsky: "Spontaneous Esophageal Rupture: Boerhaave's Syndrome," pages 177-182. Clinical Pulmonary Medicine 10(3), May 2003 abstract
- ^ Yang ST, Devanand A, Tan KL, Eng PC (2003). "Boerhaave's syndrome presenting as a right-sided pleural effusion". Ann. Acad. Med. Singap. 32 (3): 415–7. PMID 12854388.
- ^ Korn O, Oñate JC, López R (2007). "Anatomy of the Boerhaave syndrome". Surgery 141 (2): 222–8. doi:. A digital object identifier ( DOI) is a permanent identifier given to an Electronic document. PMID 17263979.
- ^ Matsuda A, Miyashita M, Sasajima K, et al (2006). "Boerhaave syndrome treated conservatively following early endoscopic diagnosis: a case report". Journal of Nippon Medical School = Nihon Ika Daigaku zasshi 73 (6): 341–5. PMID 17220586.
References
Dapyx Software network: MP3 Explorer | Ebook Manager | Zenithic