Laceration (Mallory Weiss) Flashcards
1
Q
What is the aetiology of oesophageal perforation?
A
- Iatrogenic
- barogenic (trauma, forceful repeated vomiting)
- Ingestion injury
- Carcinoma
2
Q
CFx of oesophageal perforation?
A
- neck/chest pain
- fever, tachycardia, hypotension, dyspnoea, respiratory compromise
- subcutaneous emphysema, pneumothorax, haematemesis.
3
Q
CXR finding in oesophageal perforation?
A
- Pneumo-thorax/-mediastinum
- pleural effusion
- subdiaphragmatic air
4
Q
CT chest findings of oesophageal perforation?
A
- Widened mediastinum
- Pneumomediastinum
5
Q
Contrast swallow result in oesophageal perforation?
A
Contrast extravasation
6
Q
Rx of contained oesophageal rupture?
A
- NPO
- Vigorous fluid resuscitation
- Broad spectrum ABx
- Percutaneous drainage
7
Q
Treatment of
A
-Primary closure or healthy oesophagus
OR
-Resection of disease oesophagues
8
Q
Treatment of >24h oesophageal perforation or non-viable wound edges?
A
- Diversion and exclusion
- Delayed reconstruction (oesophagostomy proximally, close oesophagus distally, gastrostomy/jejunostomy for decompression/feeding).
9
Q
Complications of oesophageal perforation?
A
- Sepsis, abscess, fistula, empyema, mediastinitis, death
- Post-op oesophageal leak
10
Q
Mortality of oesophageal perforation?
A
10-15% dependent on timing of diagnosis.
11
Q
What is Boerhaave’s syndrome?
A
Transmural oesophageal perforation.
12
Q
What is Mallory Weiss Tear?
A
Non-transmural oesophageal tear (partial thickness tear).
