Boerhaave syndrome pathophysiology

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Mohamed Diab, MD [2] Shaghayegh Habibi, M.D.[3]

Overview

Pathophysiology

  • Boerhaave syndrome is a spontaneous perforation of the esophagus due to a sudden rise in intraesophageal pressure combined with negative intrathoracic pressure (eg, severe straining, vomiting or seizures) as a result of neuromuscular incoordination resulting in a longitudinal esophageal perforation.[1]
  • Boerhaave syndrome is commonly associated with the consumption of excessive food and/or alcohol.
  • Boerhaave syndrome usually occurs in patients with a normal underlying esophagus, some patients with Boerhaave syndrome has underlying medication-induced esophagitis, eosinophilic esophagitis, Barrett's or infectious ulcers.
  • The most common anatomical location of the esophageal perforation in Boerhaave syndrome is at left posterolateral wall of the distal intrathoracic esophagus, 2-3 cm before the stomach. However, the esophageal perforation in Boerhaave syndrome can occur in the cervical or intra-abdominal esophagus.[2][3]

References

  1. Pate JW, Walker WA, Cole FH, Owen EW, Johnson WH (1989). "Spontaneous rupture of the esophagus: a 30-year experience". Ann. Thorac. Surg. 47 (5): 689–92. PMID 2730190.
  2. Korn O, Oñate JC, López R (2007). "Anatomy of the Boerhaave syndrome". Surgery. 141 (2): 222–8. doi:10.1016/j.surg.2006.06.034. PMID 17263979.
  3. Herbella FA, Matone J, Del Grande JC (2005). "Eponyms in esophageal surgery, part 2". Dis. Esophagus. 18 (1): 4–16. doi:10.1111/j.1442-2050.2005.00447.x. PMID 15773835.

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