Boerhaave syndrome pathophysiology: Difference between revisions

Jump to navigation Jump to search
Line 6: Line 6:


==Pathophysiology==
==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.<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>   
The pathophysiology of BHS is as follows:<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="pmid17263979">{{cite journal |author=Korn O, Oñate JC, López R |title=Anatomy of the Boerhaave syndrome |journal=Surgery |volume=141 |issue=2 |pages=222–8 |year=2007 |pmid=17263979 |doi=10.1016/j.surg.2006.06.034}}</ref><ref name="pmid15773835">{{cite journal |vauthors=Herbella FA, Matone J, Del Grande JC |title=Eponyms in esophageal surgery, part 2 |journal=Dis. Esophagus |volume=18 |issue=1 |pages=4–16 |year=2005 |pmid=15773835 |doi=10.1111/j.1442-2050.2005.00447.x |url=}}</ref><ref name="pmid20226056">{{cite journal |vauthors=Malik UF, Young R, Pham HD, McCon A, Shen B, Landres R, Mahmoud A |title=Chronic presentation of Boerhaave's syndrome |journal=BMC Gastroenterol |volume=10 |issue= |pages=29 |year=2010 |pmid=20226056 |pmc=2847967 |doi=10.1186/1471-230X-10-29 |url=}}</ref>
 
* 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.  
* Boerhaave syndrome is commonly associated with the consumption of excessive food and/or alcohol.  
* 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 and some patients have underlying medication-induced esophagitis, [[eosinophilic esophagitis]], [[Barrett's esophagus|Barrett's]] or infectious ulcers.  
* Boerhaave syndrome usually occurs in patients with a normal underlying esophagus and some patients has underlying medication-induced esophagitis, [[eosinophilic esophagitis]], [[Barrett's esophagus|Barrett's]] or infectious ulcers.  
* The most common anatomical location of the esophageal perforation in Boerhaave syndrome is at the left posterolateral wall of the distal intrathoracic esophagus (the distal third of the esophagus is inherently weaker than the rest of the esophagus) and 2-3 cm before the stomach. However, the esophageal perforation in Boerhaave syndrome can also occur in the cervical or intra-abdominal esophagus.
 
* The most common anatomical location of the esophageal perforation in Boerhaave syndrome is at left posterolateral wall of the distal intrathoracic esophagus (the distal third of the esophagus is inherently weaker than the rest of the esophagus) and 2-3 cm before the stomach. However, the esophageal perforation in Boerhaave syndrome can also occur in the cervical or intra-abdominal esophagus.<ref name="pmid17263979">{{cite journal |author=Korn O, Oñate JC, López R |title=Anatomy of the Boerhaave syndrome |journal=Surgery |volume=141 |issue=2 |pages=222–8 |year=2007 |pmid=17263979 |doi=10.1016/j.surg.2006.06.034}}</ref><ref name="pmid15773835">{{cite journal |vauthors=Herbella FA, Matone J, Del Grande JC |title=Eponyms in esophageal surgery, part 2 |journal=Dis. Esophagus |volume=18 |issue=1 |pages=4–16 |year=2005 |pmid=15773835 |doi=10.1111/j.1442-2050.2005.00447.x |url=}}</ref><ref name="pmid20226056">{{cite journal |vauthors=Malik UF, Young R, Pham HD, McCon A, Shen B, Landres R, Mahmoud A |title=Chronic presentation of Boerhaave's syndrome |journal=BMC Gastroenterol |volume=10 |issue= |pages=29 |year=2010 |pmid=20226056 |pmc=2847967 |doi=10.1186/1471-230X-10-29 |url=}}</ref>


==References==
==References==

Revision as of 17:22, 6 February 2018

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 pathophysiology On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Boerhaave syndrome pathophysiology

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 pathophysiology

CDC on Boerhaave syndrome pathophysiology

Boerhaave syndrome pathophysiology in the news

Blogs on Boerhaave syndrome pathophysiology

Directions to Hospitals Treating Boerhaave syndrome

Risk calculators and risk factors for Boerhaave syndrome pathophysiology

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

Boerhaave syndrome is a spontaneous longitudinal perforation of the esophagus due to a sudden rise in intraesophageal pressure combined with negative intrathoracic pressure. It is commonly associated with the consumption of excessive food and/or alcohol or underlying medication-induced esophagitis, eosinophilic esophagitis, Barrett's or infectious ulcers.

Pathophysiology

The pathophysiology of BHS is as follows:[1][2][3][4]

  • 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.
  • 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 and some patients have 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 the left posterolateral wall of the distal intrathoracic esophagus (the distal third of the esophagus is inherently weaker than the rest of the esophagus) and 2-3 cm before the stomach. However, the esophageal perforation in Boerhaave syndrome can also occur in the cervical or intra-abdominal esophagus.

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.
  4. Malik UF, Young R, Pham HD, McCon A, Shen B, Landres R, Mahmoud A (2010). "Chronic presentation of Boerhaave's syndrome". BMC Gastroenterol. 10: 29. doi:10.1186/1471-230X-10-29. PMC 2847967. PMID 20226056.

Template:WH Template:WS