Boerhaave syndrome chest x ray: Difference between revisions

Jump to navigation Jump to search
No edit summary
 
(20 intermediate revisions by 4 users not shown)
Line 1: Line 1:
__NOTOC__
__NOTOC__
{{Boerhaave syndrome}}
{{Boerhaave syndrome}}
{{CMG}} {{AE}} {{DM}} {{SHH}}
{{CMG}} {{AE}} {{DM}}, {{SHH}}, {{Ajay}}, {{FT}}
==Overview==
==Overview==
Very useful initial diagnostic test and is abnormal in most patients with perforation which shows: unilateral effusion usually on the left, pneumothorax, hydropneumothorax, pneumomediastinum, mediastinal widening.
An upright anterior-posterior view of the chest is the most useful in early diagnosis. In most patients with [[Boerhaave syndrome]] (BHS) [[chest x-ray]] shows one-sided effusion, [[pneumothorax]], [[hydropneumothorax]], [[pneumomediastinum]] and [[subcutaneous emphysema]].


==Chest X Ray==
==Chest X Ray==
Erect Radiograph chest posteroanterior view is the most useful in early diagnosis, as most of the patients will reveal an abnormal chest finding after the perforation.8 The V-sign of Naclerio may be seen on chest radiograph as radiolucent streaks of air seen in the retrocardiac region in the shape of the letter V. However, the most common finding is a one-sided pleural effusion or hydropneumothorax, other features such as pneumomediastinum or surgical emphysema may also be seen.
* An upright anterior-posterior view of the chest is the most useful in early diagnosis, as most of the patients will reveal an abnormal chest finding after the [[perforation]].  
* The '''Naclerio V-sign''' may be seen on chest [[Radiography|radiograph]] as radiolucent streaks of air seen in the retro-[[cardiac]] region in the V shape.<ref name="pmid28050085">{{cite journal |vauthors=Maurya VK, Sharma P, Ravikumar R, Bhatia M |title=Boerhaave's syndrome |journal=Med J Armed Forces India |volume=72 |issue=Suppl 1 |pages=S105–S107 |year=2016 |pmid=28050085 |pmc=5192176 |doi=10.1016/j.mjafi.2015.12.004 |url=}}</ref>
The usual although unspecific radiographic features of BHS include:<ref name="pmid23493470">{{cite journal |vauthors=Tonolini M, Bianco R |title=Spontaneous esophageal perforation (Boerhaave syndrome): Diagnosis with CT-esophagography |journal=J Emerg Trauma Shock |volume=6 |issue=1 |pages=58–60 |year=2013 |pmid=23493470 |pmc=3589863 |doi=10.4103/0974-2700.106329 |url=}}</ref>
* One-sided [[effusion]] (usually on the left)
* Lung infiltrates
* [[Atelectasis]]
Whereas more specific signs are rarely detected or very subtle:<ref name="pmid28050085">{{cite journal |vauthors=Maurya VK, Sharma P, Ravikumar R, Bhatia M |title=Boerhaave's syndrome |journal=Med J Armed Forces India |volume=72 |issue=Suppl 1 |pages=S105–S107 |year=2016 |pmid=28050085 |pmc=5192176 |doi=10.1016/j.mjafi.2015.12.004 |url=}}</ref><ref name="pmid2730190">{{cite journal |vauthors=Pate JW, Walker WA, Cole FH, Owen EW, Johnson WH |title=Spontaneous rupture of the esophagus: a 30-year experience |journal=Ann. Thorac. Surg. |volume=47 |issue=5 |pages=689–92 |year=1989 |pmid=2730190 |doi= |url=}}</ref><ref name="pmid23493470">{{cite journal |vauthors=Tonolini M, Bianco R |title=Spontaneous esophageal perforation (Boerhaave syndrome): Diagnosis with CT-esophagography |journal=J Emerg Trauma Shock |volume=6 |issue=1 |pages=58–60 |year=2013 |pmid=23493470 |pmc=3589863 |doi=10.4103/0974-2700.106329 |url=}}</ref>
* [[Pneumothorax]]
* [[Hydropneumothorax]]
* [[Pneumomediastinum]]
* [[Widened mediastinum|Mediastinal widening]]
* [[Pneumopericardium]]
* [[Subcutaneous emphysema]]


Very useful initial diagnostic test and is abnormal in most patients with perforation which shows:<ref name="pmid2730190">{{cite journal |vauthors=Pate JW, Walker WA, Cole FH, Owen EW, Johnson WH |title=Spontaneous rupture of the esophagus: a 30-year experience |journal=Ann. Thorac. Surg. |volume=47 |issue=5 |pages=689–92 |year=1989 |pmid=2730190 |doi= |url=}}</ref>
<gallery>
* Unilateral effusion usually on the left.
Image: CXR-BHS.jpg|'''Chest X-ray: Frontal view reveals pneumomediastinum (black arrows). Subcutaneous emphysema (red arrow) along the chest wall, more prominent along the right than left; Source- Radiopaedia'''
*  Pneumothorax
Image: CXR BHS-2.jpg|'''Chest X-ray: Boerhaave syndrome- Lateral radiographs subcutaneous emphysema (red arrow) along the chest wall; Source- Radiopaedia'''
* Hydropneumothorax
</gallery>
* Pneumomediastinum
* Subcutaneous emphysema
* Mediastinal widening.


==References==
==References==

Latest revision as of 19:22, 17 February 2021

Boerhaave syndrome Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Boerhaave syndrome from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Study of Choice

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

Chest X Ray

CT

MRI

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Boerhaave syndrome chest x ray On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Boerhaave syndrome chest x ray

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Boerhaave syndrome chest x ray

CDC on Boerhaave syndrome chest x ray

Boerhaave syndrome chest x ray in the news

Blogs on Boerhaave syndrome chest x ray

Directions to Hospitals Treating Boerhaave syndrome

Risk calculators and risk factors for Boerhaave syndrome chest x ray

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], Ajay Gade MD[4]], Feham Tariq, MD [5]

Overview

An upright anterior-posterior view of the chest is the most useful in early diagnosis. In most patients with Boerhaave syndrome (BHS) chest x-ray shows one-sided effusion, pneumothorax, hydropneumothorax, pneumomediastinum and subcutaneous emphysema.

Chest X Ray

  • An upright anterior-posterior view of the chest is the most useful in early diagnosis, as most of the patients will reveal an abnormal chest finding after the perforation.
  • The Naclerio V-sign may be seen on chest radiograph as radiolucent streaks of air seen in the retro-cardiac region in the V shape.[1]

The usual although unspecific radiographic features of BHS include:[2]

Whereas more specific signs are rarely detected or very subtle:[1][3][2]

References

  1. 1.0 1.1 Maurya VK, Sharma P, Ravikumar R, Bhatia M (2016). "Boerhaave's syndrome". Med J Armed Forces India. 72 (Suppl 1): S105–S107. doi:10.1016/j.mjafi.2015.12.004. PMC 5192176. PMID 28050085.
  2. 2.0 2.1 Tonolini M, Bianco R (2013). "Spontaneous esophageal perforation (Boerhaave syndrome): Diagnosis with CT-esophagography". J Emerg Trauma Shock. 6 (1): 58–60. doi:10.4103/0974-2700.106329. PMC 3589863. PMID 23493470.
  3. 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.

Template:WH Template:WS