[Spontaneous contained perforation of a hiatal hernia. A new equivalent of Boerhaave's syndrome].
The authors report the case of an alcoholic 49-year-old man hospitalized because of epigastric pain and hematemesis. Upper endoscopy showed a tear in a hiatus hernia (interpreted as a Mallory-Weiss lesion) and a bleeding duodenal ulcer. Upper barium examination performed 16 days later revealed a mediastinal collection communicating with the hiatus hernia. Retrospective evaluation of chest roentgenograms obtained at admission showed a limited mediastinal gas collection. With medical management, the collection progressively disappeared. From a theoretical point of view, this case illustrates Watts' theory on the effect of hiatus hernia on the site of postemetic injury. From a practical point of view, it confirms that conservative management is indicated in contained spontaneous perforations.
Delamarre
J
J
Service de Radiologie A, CHU Nord, Amiens.
Papazian
A
A
Capron
J P
JP
Dupas
J L
JL
Gondry-Jouet
C
C
Deschepper
B
B
D004939:Esophageal Perforation / Q000209:etiology*; D006548:Hernia, Diaphragmatic; D006551:Hernia, Hiatal / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012422:Rupture, Spontaneous; D014839:Vomiting / Q000150:complications*
Perforation "spontanée" cloisonnée d'une hernie hiatale. Un nouvel équivalent du syndrome de Boerhaave.