Boerhaave syndrome natural history, complications and prognosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Shaghayegh Habibi, M.D.[2], Ajay Gade MD[3]], Feham Tariq, MD [4]
Overview
Boerhaave syndrome (BHS), if left untreated, mortality will reach 100%. Survival of Boerhaave's syndrome is witin days. Most common complications of Boerhaave syndrome include pneumomediastinum, mediastinitis, sepsis, posterior mediastinal abscess. Boerhaave's syndrome has a high mortality rate (14-40%).
Natural History
- The natural history of BHS is as follows:[1][2]
- Diagnosis of Boerhaave's syndrome can easily be missed or delayed, leading to complications like dehydration, mediastinitis, sepsis and shock.
- This accounts for the high mortality rate. If appropriate treatment is not started on time and if left untreated, the mortality rate reaches 100%.
- Without adequate treatment, survival of Boerhaave's syndrome is within days.
Complications
Most common complications of Boerhaave syndrome include:[3][4]
- Pneumomediastinum (air in the mediastinum)
- Mediastinitis (inflammation of the mediastinum)
- Infection and sepsis (fever, hypotension, and altered level of consciousness)
- Posterior mediastinal abscess
Prognosis
Boerhaave's syndrome has a high mortality rate (14-40%).The non-specific clinical signs contribute to the poor outcome of Boerhaave syndrome. [5][6]
References
- ↑ Tamatey MN, Sereboe LA, Tettey MM, Entsua-Mensah K, Gyan B (2013). "Boerhaave's syndrome: diagnosis and successful primary repair one month after the oesophageal perforation". Ghana Med J. 47 (1): 53–5. PMC 3645189. PMID 23661858.
- ↑ Boerhaave syndrome at eMedicine
- ↑ Ahmad R, Ishlah W, Shaharudin MH, Sathananthar KS, Norie A (2008). "Posterior mediastinal abscess secondary to esophageal perforation following fish bone ingestion". Med. J. Malaysia. 63 (2): 162–3. PMID 18942310.
- ↑ Maurya VK, Sharma P, Ravikumar R, Bhatia M (2016). "Boerhaave's syndrome". Med J Armed Forces India. 72 (Suppl 1): S105–S107. doi:10.1016/j.mjafi.2015.12.004. PMC 5192176. PMID 28050085.
- ↑ Haveman JW, Nieuwenhuijs VB, Kobold JP, van Dam GM, Plukker JT, Hofker HS (2011). "Adequate debridement and drainage of the mediastinum using open thoracotomy or video-assisted thoracoscopic surgery for Boerhaave's syndrome". Surg Endosc. 25 (8): 2492–7. doi:10.1007/s00464-011-1571-y. PMC 3142333. PMID 21359901.
- ↑ Lu H, Carron PN, Godat S, Pittet R (2018). "[Boerhaave syndrome: update on physiopathology, diagnosis and early management]". Rev Med Suisse (in French). 14 (592): 299–303. PMID 29384279.