upper GI Flashcards
what is the imaging of choice for suspected borhaves?
CT contrast swallow
which classically shows pneumomediastinum
what is borhaves?
spontaneous rupture of the oesophagus usually after repeated vomiting/retching. The history of binge drinking is common.
what is the difference between borhaves and makkory Weiss tear?
Borhaves is transmural and mallory Weiss is not
what is the classic presentation for boerhaves?
It classically occurs in middle aged alcoholic men after repeating vomiting. It presents as:
Severe tearing chest pain worse on swallowing
Little/no haematemsis
Signs of shock
Subcutaneous emphysema
Pneumomediastinum, pleural effusions, pneumothorax on x-ray
why is OGD avoided in boerhaves?
increases the risk of perforation
what is the management of boerhaves?
IV fluid resuscitation
IV antibiotics to cover/treat mediastinitis
Surgical correction
what is the triad for Plummer Vinson syndrome? and what is the treatment?
Triad of:
dysphagia (secondary to oesophageal webs)
glossitis
iron-deficiency anaemia
Treatment includes iron supplementation and dilation of the webs
