Boerhaave Syndrome

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Boerhaave syndrome, also known spontaneous esophageal rupture, is a rare (accounting for only 16% of all traumatic ruptures of the esophagus) but serious condition. Boerhaave Syndrome is characterized by a complete transmural rupture of the esophagus resulting from forceful vomiting (causing barogenic trauma).

Uncoordinated vomiting with pyloric closure and diaphragmatic contraction against a contracted cricopharyngeal muscle causing a sudden rise in intraluminal pressure is theorized to be the underlying cause of Boerhaave syndrome. The most common site of rupture is the left posterolateral wall of the lower third of the esophagus, which is the weakest point of the esophagus.

There is an association between Boerhaave syndrome and an overindulgence in alcohol and food, as expected from a condition that is associated with vomiting. Boerhaave syndrome has a significantly increased incidence in men as compared with women, with a ratio of approximately 2:1.

Boerhaave syndrome typically presents with a history of nausea and vomiting, followed by severe lower thoracic and epigastric pain. The pain may radiate to the back or to the left shoulder, and may be worsened by swallowing. Vomiting blood (hematemesis) is typically not a complaint with esophageal rupture, and this can help to differentiate it from a Mallory-Weiss tear.

Another common complaint with Boerhaave syndrome is shortness of breath, resulting from pleuritic chest pain or a pleural effusion.

The classic presentation seen in Boerhaave syndrome is known as The Mackler Triad. Other classic findings include rapid respirations (tachypnea) and abdominal rigidity.

Unusual (atypical) findings in Boerhaave Syndrome include peripheral cyanosis, hoarseness caused by involvement of the recurrent laryngeal nerve, tracheal shift, cervical vein distention, and proptosis. Nonspecific findings include tachycardia, diaphoresis, fever, and hypotension, especially as the condition evolves. More advanced stages of rupture typically present as sepsis with progression toward multi-organ failure. Despite these symptoms and signs, the clinical presentation of Boerhaave Syndrome can be variable and, often, the classic triad of symptoms and signs (ie, the Mackler Triad) can be absent, which can make establishing the diagnosis difficult.

My situation

I had just finished eating some Mexican food. A good meal with the exception of one mouthful, I bit into an enchalata that had a pepper hidden inside. As I bit into the pepper and the seeds and juice squirted in my mouth, it mixed with food already in my mouth. I took the pepper out of my mouth but chewed and swallowed the mouthful of food. Should've spit the whole mouthful out. I don't do hot and spicy well. It seamed like a very hot pepper. As I finished the meal and left the restaurant I was feeling stuffed. Went shopping to pick up a few things. Had a bowel movement and throw up. So I went back to my apartment to get some rest with and try to settle my stomach. I had some ginger ail, it didn't work. Vomited again and couldn't catch my breath. Thought that I was just tired. Took a nap. Woke up panting like a dog. Could not catch my breath. Drive myself to the hospital, I was admitted. After a wrong diagnosis of having walking pneumonia. I told them no not walking pneumonia. I felt fine until the second vomit. After a battery of xrays, CT scans, ultrasounds, and MRIs, I was told that I had a perforated esophagus and without surgery I would die, even with the surgery it was 50/50 whether I would survive. This started at the end of August, now it is February and I am still healing.

 That's quite intense!!

 That's quite intense!! Was the vomitting quite violent?  
Glad you're on the mend!

Boerhaaave's Syndrome

Last night, I awakened with sharp pains in
my chest,bubbles in the chest, heat coming
from the bubbles. I have been vomiting
a lot (everyday to every other day)some
times twice in a day. I also had pain on
my upper left side of my back. Other than
that, I feel fine and did work in the
yard today, trimming branches for the
upcoming hurricanes. I don't know if I
need to see a doctor, it may have been
gas under the ribs. I hate going to a
doctor. Just went to HMO and need to get
a new general doctor. I've been eating
a lot of cucumbers and tomatoes.

 I would definitely

 I would definitely recommend that you go see a doctor.

You are an idiot

You are an idiot