[Boerhaave's syndrome: also in the emergency room].
Two men, aged 52 and 57 years, had vomited and then developed chest pain, dyspnoea and tachypnoea. After a myocardial infarction had been excluded in the cardiac emergency room, further examination revealed a rupture of the oesophagus. This was treated surgically with the ultimate creation of a tubular stomach. Both patients then recovered well. The Boerhaave's syndrome, a 'spontaneous' perforation of the oesophagus, is a rare and potentially lethal condition which should be diagnosed at an early stage. Pain in the chest, dyspnoea and vomiting are frequent symptoms. A cardiac cause is sometimes erroneously suspected. Subcutaneous emphysema is a major indication for a perforation of the oesophagus. The chest X-ray shows also mediastinal emphysema and infiltrative abnormalities; in case of doubt a second X-ray should be made some hours later.
van Winkel
A T
AT
Afd. Cardiologie, Gelre Ziekenhuizen, Postbus 9014, 7300 DS Apeldoorn.
Meijs
M M
MM
Hesselink
E J
EJ
Bendien
C
C
Liem
K S
KS
D002637:Chest Pain / Q000209:etiology; D003937:Diagnosis, Differential; D004417:Dyspnea / Q000209:etiology; D004636:Emergency Service, Hospital; D004638:Emergency Treatment / Q000379:methods*; D004935:Esophageal Diseases / Q000150:complications / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D004947:Esophagus / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis; D011859:Radiography; D012422:Rupture, Spontaneous; D013577:Syndrome; D016896:Treatment Outcome; D014839:Vomiting / Q000209:etiology