Boerhaave's Syndrome: Still a Diagnostic and Therapeutic Challenge in the 21st Century

Boerhaave's Syndrome: Still a Diagnostic and Therapeutic Challenge in the 21st Century

Boerhaave's syndrome is a rare but potentially fatal condition characterised by a transmural tear of the distal oesophagus induced by a sudden increase in pressure. Diagnosis is challenging as the classic triad of vomiting, abdominal or chest pain, and subcutaneous emphysema is absent in many p...

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Main Authors: J. Spapen, J. De Regt, K. Nieboer, G. Verfaillie, P. M. Honoré, H. Spapen
Format: Article
Language:English
Published: Hindawi Limited 2013-01-01
Series:Case Reports in Critical Care
Online Access:http://dx.doi.org/10.1155/2013/161286
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spelling doaj-e62251e32f3142759eee85b31ff0b5962020-11-24T23:10:00ZengHindawi LimitedCase Reports in Critical Care2090-64202090-64392013-01-01201310.1155/2013/161286161286Boerhaave's Syndrome: Still a Diagnostic and Therapeutic Challenge in the 21st CenturyJ. Spapen0J. De Regt1K. Nieboer2G. Verfaillie3P. M. Honoré4H. Spapen5Department of Internal Medicine, University Hospital, Vrije Universiteit Brussel, Laarbeeklaan 101, 1090 Brussels, BelgiumDepartment of Intensive Care, University Hospital, Vrije Universiteit Brussel, Laarbeeklaan 101, 1090 Brussels, BelgiumDepartment of Radiology, University Hospital, Vrije Universiteit Brussel, Laarbeeklaan 101, 1090 Brussels, BelgiumDepartment of Thoracic Surgery, University Hospital, Vrije Universiteit Brussel, Laarbeeklaan 101, 1090 Brussels, BelgiumDepartment of Intensive Care, University Hospital, Vrije Universiteit Brussel, Laarbeeklaan 101, 1090 Brussels, BelgiumDepartment of Intensive Care, University Hospital, Vrije Universiteit Brussel, Laarbeeklaan 101, 1090 Brussels, BelgiumBoerhaave's syndrome is a rare but potentially fatal condition characterised by a transmural tear of the distal oesophagus induced by a sudden increase in pressure. Diagnosis is challenging as the classic triad of vomiting, abdominal or chest pain, and subcutaneous emphysema is absent in many patients. Management is multidisciplinary and relies on rapid, distinct, and repeated imaging. Treatment has not been standardised and may be conservative, endoscopic, or surgical. We present a typical case which illustrates possible diagnostic pitfalls and the therapeutic conundrum surrounding management of the syndrome. Based on time of presentation and eventual presence of sepsis, a therapeutic algorithm is proposed.http://dx.doi.org/10.1155/2013/161286
collection DOAJ
language English
format Article
sources DOAJ
author J. Spapen
J. De Regt
K. Nieboer
G. Verfaillie
P. M. Honoré
H. Spapen
spellingShingle J. Spapen
J. De Regt
K. Nieboer
G. Verfaillie
P. M. Honoré
H. Spapen
Boerhaave's Syndrome: Still a Diagnostic and Therapeutic Challenge in the 21st Century
Case Reports in Critical Care
author_facet J. Spapen
J. De Regt
K. Nieboer
G. Verfaillie
P. M. Honoré
H. Spapen
author_sort J. Spapen
title Boerhaave's Syndrome: Still a Diagnostic and Therapeutic Challenge in the 21st Century
title_short Boerhaave's Syndrome: Still a Diagnostic and Therapeutic Challenge in the 21st Century
title_full Boerhaave's Syndrome: Still a Diagnostic and Therapeutic Challenge in the 21st Century
title_fullStr Boerhaave's Syndrome: Still a Diagnostic and Therapeutic Challenge in the 21st Century
title_full_unstemmed Boerhaave's Syndrome: Still a Diagnostic and Therapeutic Challenge in the 21st Century
title_sort boerhaave's syndrome: still a diagnostic and therapeutic challenge in the 21st century
publisher Hindawi Limited
series Case Reports in Critical Care
issn 2090-6420
2090-6439
publishDate 2013-01-01
description Boerhaave's syndrome is a rare but potentially fatal condition characterised by a transmural tear of the distal oesophagus induced by a sudden increase in pressure. Diagnosis is challenging as the classic triad of vomiting, abdominal or chest pain, and subcutaneous emphysema is absent in many patients. Management is multidisciplinary and relies on rapid, distinct, and repeated imaging. Treatment has not been standardised and may be conservative, endoscopic, or surgical. We present a typical case which illustrates possible diagnostic pitfalls and the therapeutic conundrum surrounding management of the syndrome. Based on time of presentation and eventual presence of sepsis, a therapeutic algorithm is proposed.
url http://dx.doi.org/10.1155/2013/161286
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