Clinical features
The clinical symptoms of Boerhaave's syndrome include:
- characteristically seen in middle aged men (but it can occur at any age and in both sexes) with a history of high alcohol intake, 'retching' and vomiting although up to 45% may have no history of vomiting on presentation (1)
- a history of retrosternal pain progressing to to excruciating epigastric pain that is increased by swallowing
- failure of opiates to relieve pain
Signs of Boerhaave's syndrome include:
- respiratory collapse:
- dyspnoea
- cyanosis
- shock
- subcutaneous emphysema in the neck
- hydrothorax
- pneumothorax (both a hydrothorax and pneumothorax may take some hours to develop)
- pleural effusion
- tenderness over epigastrium and rigidity
Reference
- van der Weg G, Wikkeling M, van Leeuwen M, Ter Avest E. A rare case of oesophageal rupture: Boerhaave's syndrome. Int J Emerg Med. 2014;7:27.
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