Tension hydropneumothorax as the initial presentation of Boerhaave syndrome
Boerhaave syndrome, a rare yet frequently fatal diagnosis, is characterized by the spontaneous transmural rupture of the esophagus. The classic presentation of Boerhaave syndrome is characterized by Mackler's triad, consisting of chest pain, vomiting, and subcutaneous emphysema. However, Boerha...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2018-01-01
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| Series: | Respiratory Medicine Case Reports |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S221300711830203X |
| _version_ | 1817987762695962624 |
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| author | Michelle-Thao Lieu Michael E. Layoun David Dai Guy W. Soo Hoo Jaime Betancourt |
| author_facet | Michelle-Thao Lieu Michael E. Layoun David Dai Guy W. Soo Hoo Jaime Betancourt |
| author_sort | Michelle-Thao Lieu |
| collection | DOAJ |
| description | Boerhaave syndrome, a rare yet frequently fatal diagnosis, is characterized by the spontaneous transmural rupture of the esophagus. The classic presentation of Boerhaave syndrome is characterized by Mackler's triad, consisting of chest pain, vomiting, and subcutaneous emphysema. However, Boerhaave syndrome rarely presents with all the features of Mackler's triad; instead, the common presentation of Boerhaave syndrome includes chest or epigastric pain, severe retching and vomiting, dyspnea, and shock. These symptoms are typically misdiagnosed as cardiogenic in origin. Due to its atypical presentation, rarity, and mimicry of emergent conditions, diagnosis of Boerhaave syndrome is often delayed, resulting in a high mortality rate at the time of diagnosis and with a subsequent exponential increase in mortality if treatment is delayed by greater than 48 hours. Here, we report two atypical presentations of Boerhaave syndrome presenting as tension hydropneumothorax and review ten previously reported cases of Boerhaave syndrome presenting as tension hydropneumothorax. This review serves to raise clinician awareness about the expansive and elusive ways by which esophageal perforation may present, and thereby facilitate timely and potentially life-saving diagnosis. Keywords: Boerhaave syndrome, Tension hydropneumothorax, Tension pneumothorax, Esophageal rupture, Mackler's triad, Esophageal perforation |
| first_indexed | 2024-04-14T00:25:51Z |
| format | Article |
| id | doaj.art-9b4ab976303f4f01a67bec2fb3bccfe5 |
| institution | Directory Open Access Journal |
| issn | 2213-0071 |
| language | English |
| last_indexed | 2024-04-14T00:25:51Z |
| publishDate | 2018-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Respiratory Medicine Case Reports |
| spelling | doaj.art-9b4ab976303f4f01a67bec2fb3bccfe52022-12-22T02:22:45ZengElsevierRespiratory Medicine Case Reports2213-00712018-01-0125100103Tension hydropneumothorax as the initial presentation of Boerhaave syndromeMichelle-Thao Lieu0Michael E. Layoun1David Dai2Guy W. Soo Hoo3Jaime Betancourt4Department of Anesthesiology & Perioperative Medicine, David Geffen School of Medicine at University of California, Los Angeles, USA; Corresponding author. 757 Westwood Plaza, Suite 3304, Los Angeles, CA 90095-7403, USA.Knight Cardiovascular Institute, Division of Cardiology, Department of Medicine, Oregon Health and Sciences University, USADepartment of Medicine, Pulmonary & Critical Care Section, David Geffen School of Medicine at University of California, Los Angeles, USADepartment of Medicine, Pulmonary & Critical Care Section, David Geffen School of Medicine at University of California, Los Angeles, USA; Department of Medicine, Pulmonary & Critical Care Section, VA Greater Los Angeles Healthcare System, USADepartment of Medicine, Pulmonary & Critical Care Section, David Geffen School of Medicine at University of California, Los Angeles, USA; Department of Medicine, Pulmonary & Critical Care Section, VA Greater Los Angeles Healthcare System, USABoerhaave syndrome, a rare yet frequently fatal diagnosis, is characterized by the spontaneous transmural rupture of the esophagus. The classic presentation of Boerhaave syndrome is characterized by Mackler's triad, consisting of chest pain, vomiting, and subcutaneous emphysema. However, Boerhaave syndrome rarely presents with all the features of Mackler's triad; instead, the common presentation of Boerhaave syndrome includes chest or epigastric pain, severe retching and vomiting, dyspnea, and shock. These symptoms are typically misdiagnosed as cardiogenic in origin. Due to its atypical presentation, rarity, and mimicry of emergent conditions, diagnosis of Boerhaave syndrome is often delayed, resulting in a high mortality rate at the time of diagnosis and with a subsequent exponential increase in mortality if treatment is delayed by greater than 48 hours. Here, we report two atypical presentations of Boerhaave syndrome presenting as tension hydropneumothorax and review ten previously reported cases of Boerhaave syndrome presenting as tension hydropneumothorax. This review serves to raise clinician awareness about the expansive and elusive ways by which esophageal perforation may present, and thereby facilitate timely and potentially life-saving diagnosis. Keywords: Boerhaave syndrome, Tension hydropneumothorax, Tension pneumothorax, Esophageal rupture, Mackler's triad, Esophageal perforationhttp://www.sciencedirect.com/science/article/pii/S221300711830203X |
| spellingShingle | Michelle-Thao Lieu Michael E. Layoun David Dai Guy W. Soo Hoo Jaime Betancourt Tension hydropneumothorax as the initial presentation of Boerhaave syndrome Respiratory Medicine Case Reports |
| title | Tension hydropneumothorax as the initial presentation of Boerhaave syndrome |
| title_full | Tension hydropneumothorax as the initial presentation of Boerhaave syndrome |
| title_fullStr | Tension hydropneumothorax as the initial presentation of Boerhaave syndrome |
| title_full_unstemmed | Tension hydropneumothorax as the initial presentation of Boerhaave syndrome |
| title_short | Tension hydropneumothorax as the initial presentation of Boerhaave syndrome |
| title_sort | tension hydropneumothorax as the initial presentation of boerhaave syndrome |
| url | http://www.sciencedirect.com/science/article/pii/S221300711830203X |
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