Boerhaave's Syndrome

Question 1

What is Boerhaave syndrome?

Answer 1

Complication of M-W tear, a.k.a. oesophageal tear/rupture

Question 2

Symptoms of Boerhaave’s?

Answer 2

Chest pain, vomiting, likely in shock

Question 3

Clinical signs of Boerhaave’s/oesophageal rupture?

Answer 3

Pleural effusion
Pneumomediastinum
Subcutaneous emphysema (air trapped in subcutaneous tissues)

Question 4

Management of Boerhaave’s?

Answer 4

Surgical repair within 12 hours

- condition has 35% mortality, the highest of any GI perforation

Question 5

What is Mackler’s triad?

Answer 5

Triad of symptoms/signs indicating Boerhaave’s syndrome/oesophageal rupture

• chest pain
• vomiting
• subcutaneous emphysema

Question 6

What is Hamman’s sign?

Answer 6

Crunching sound on heart auscultation due to pneumomediastinum caused by Boerhaave’s syndrome/oesophageal rupture