Boerhaave syndrome (aka effort rupture of the
esophagus) accounts for 10% of esophageal ruptures and is usually
caused by strain during vomiting episodes. It can also be caused by
childbirth, seizure, or prolonged coughing or laughing.
Food
and water swallowed after the tear end up in the mediastinum,
eventually causing infection. Therefore, Boerhaave syndrome is a
surgical emergency.
Best
diagnostic techniques are CT or endoscopy.
Mallory-Weiss syndrome may present similarly,
however it is less serious since it involves only a small tear
through the mucosa at the gastroesophageal junction. This can be
managed on an outpatient basis with PPI’s.
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