Rupture of the oesophagus (Boerhaave's syndrome) is a rare complication of forceful or suppressed vomiting. Postoperative nausea and vomiting is common but does not usually lead to life-threatening complications. A case of oesophageal rupture in a man who experienced postoperative nausea and vomiting after an uncomplicated procedure is described in this report. Delayed diagnosis mandated conservative treatment. The clinical presentation, diagnosis and management of oesophageal rupture is discussed.
References
1.
BoerhaaveH.Atrocis, nec Descripti Prius, Morbi Historica. The First Translation of the Classic Case Report of Rupture of the Esophagus, with Annotations by Derbes VJ and Mitchell RE.Bull Med Libr Ass1955; 43: 217–240.
2.
Blichert-ToftM.Spontaneous Oesophageal Rupture. An evaluation of the results of treatment 1944–1969.Scan J Thor Cardiovasc Surg1971; 5: 111–115.
3.
LarssonS., LundbergD.A prospective survey of postoperative nausea and vomiting with special regard to incidence and relations to patient characteristics, anesthetic routines and surgical procedures.Acta Anaesthesiol Scand1995; 39: 539–545.
4.
McKieB.D.Postoperative nausea and vomiting: A review of their incidence, causes and effects.Aust NZ J Surg1970; 39: 311–314.
5.
BremnerW.G.M., KumarC.M.Delayed surgical emphysema, pneumomediastinum and bilateral pneumothoraces after postoperative vomiting.Br J Anaesth1993; 71: 296–297.
6.
BiswasJ.H., RaghavanC., SevcikL.Gastropleural fistula: An unusual cause of intractable postoperative nausea and vomiting.Anesth Analg1996; 3: 186–188.
7.
VatashskyE., HaskeY., AronsonH.B.Esophageal rupture and spinal anesthesia.Anesth Analg1983; 62: 606–608.
8.
RalphS.J., WarehamC.A.Rupture of the oesophagus during cricoid pressure.Anaesthesia1991; 46: 40–41.
9.
SmythA.R., WastellC.Spontaneous rupture of the oesophagus (Boerhaave's syndrome): delayed diagnosis and successful conservative management.JR Soc Med1989; 82: 498.
10.
WuC.S., ChangK.Y., KuoY.C.. Clinical challenge—An experience of spontaneous transmural rupture of the oesophagus in Taiwan.Br J Clin Pract1996; 50: 298–301.
NehraD., BeynonJ., PykeJ.K.Spontaneous rupture of the oesophagus (Boerhaave's syndrome).Postgrad Med J1993; 69: 214–216.
13.
WalkerW.S., CameronE.W.J., WalbaumP.R.Diagnosis and management of spontaneous transmural rupture of the oesophagus (Boerhaave's syndrome).Br J Surg1985; 72: 204–207.
14.
PateJ.W., WalkerW.A., ColeF.H.. Spontaneous Rupture of the Esophagus: A 30-year Experience.Ann Thorac Surg1989; 47: 689–692.
15.
DruryM., AndersonW., HeffnerJ.E.Diagnostic Value of Pleural Fluid Cytology in occult Boerhaave's syndrome.Chest1992; 102: 976–978.
16.
MaglinteD.D.T., EdwardsM.Spontaneous Closure of esophageal tear in Boerhaave's syndrome.Gastrointest Radiol1979; 4: 223–225.
17.
LevineM.Oral contrast material for the fluoroscopic diagnosis of esophageal rupture.(Q&A) Aust J Radiol1994; 162: 1243.
18.
ScottH.J., RosinR.D.Thoracoscopic repair of a transmural rupture of the oesophagus (Boerhaave's syndrome).J R Soc Med1995; 88: 414P–415P.
19.
TroumS., LaneC.E., DaltonM.L.Surviving Boerhaave's syndrome without thoracotomy.Chest1994; 106: 297.
20.
AgarwelK., MillerS.E.P.Spontaneous rupture of the oesophagus: Case report of delayed diagnosis and subsequent management.JR Soc Med1995; 88: 149–150.
