Boerhaave's syndrome: a pediatric case.
BACKGROUND
The term Boerhaave's syndrome refers to esophageal rupture after a sudden increase in intraluminal pressure. This syndrome is most common among alcoholic adult men. This case report is that of a pediatric patient with a similar pathologic process.


METHODS
A 6-month-old Hispanic boy with acute lymphoblastic leukemia on chemotherapy arrested 3 weeks into his induction therapy. Diagnostic and therapeutic procedures revealed a hydropneumothorax, which was managed with chest tube drainage. The underlying etiology was revealed 10 days later when feeds were introduced and found exiting the chest tube. A contrast study confirmed esophageal perforation, which was surgically repaired.


CONCLUSIONS
A nontraumatic hydropneumothorax should raise the possibility of Boerhaave's syndrome (spontaneous esophageal rupture), even in pediatric patients. Such a finding warrants a contrast study to facilitate early diagnosis.
Ramsook
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Department of Pediatrics, Section of Emergency Medicine, Baylor College of Medicine, Texas Children's Hospital, 6621 Fannin Street MC 1-1481, Houston, TX 77030-2399, U.S.A. caramsoo@pol.net
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D003937:Diagnosis, Differential; D004935:Esophageal Diseases / Q000175:diagnosis*; D006801:Humans; D007223:Infant; D008297:Male; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy; D012422:Rupture, Spontaneous; D013577:Syndrome; D014839:Vomiting / Q000139:chemically induced / Q000150:complications