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Boerhaave syndrome - case report.
Biljana Radovanovic Dinic1, Goran Ilic2, Snezana Tesic Rajkovic3
1MD. Associate Professor and Attending Physician, Medical School, University of Niš, and Gastroenterology and Hepatology Clinic, Niš Clinical Center, Niš, Serbia.
Boerhaave syndrome, a rare esophageal rupture, can present with hematemesis. Early recognition of gastrointestinal and pulmonary symptoms is crucial for diagnosis.
Area of Science:
- Gastroenterology
- Thoracic Surgery
- Pathology
Background:
- Boerhaave syndrome is a spontaneous esophageal rupture, often linked to increased intraluminal pressure during vomiting.
- It is a rare condition with a high mortality rate, sometimes presenting with Mackler's triad (vomiting, thoracic pain, subcutaneous emphysema).
Observation:
- A case report details a 64-year-old female with hematemesis, epigastric pain, and suffocation.
- Clinical examination revealed hypotension, tachycardia, dyspnea, abdominal distension, and crackling sounds.
- Initial investigations showed a fluid-filled stomach and significant upper gastrointestinal bleeding.
Findings:
- Esophagogastroduodenoscopy was halted due to massive upper GI bleeding.
- The patient underwent emergency surgery and subsequently died.
- Autopsy confirmed Boerhaave syndrome and a duodenal bulb ulceration.
Implications:
- Hematemesis is an uncommon but critical presentation of Boerhaave syndrome.
- The syndrome should be suspected in patients with combined gastrointestinal and pulmonary symptoms.
- Prompt diagnosis and management are vital due to the condition's severity.
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