Boerhaave syndrome.

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Date: Sept. 27, 2021
From: CMAJ: Canadian Medical Association Journal(Vol. 193, Issue 38)
Publisher: CMA Joule Inc.
Document Type: Clinical report
Length: 672 words
Lexile Measure: 1510L

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A 46-year-old man presented to the emergency department having had 2 large, nonbloody vomits and abdominal pain over the preceding 3 hours. He had no history of gastresophageal reflux disease or other relevant medical conditions. He had a 20-year history of drinking 10-15 cans of beer a week. On examination, his abdomen was rigid and tender in the left upper quadrant. Laboratory results showed elevated leukocytes at 13.8 (normal 4.5-11.5) * [10.sup.9]/L with 77.8% neutrophils and high sensitivity C-reactive protein of < 0.02 (normal < 0.80) mg/dL. A chest radiograph showed pneumomediastinum (Figure 1A), and a subsequent computed tomography scan of the patient's chest also showed pneumomediastinum and left hydropneumothorax (Figure 1B). We diagnosed Boerhaave syndrome, perforation of the esophagus.

The patient underwent esophageal repair and decortication of the pleura, with placement of a drainage gastrostomy and a feeding jejunostomy. During surgery, a 1.5 cm laceration was found at the lower thoracic esophagus (Appendix 1, available at www.cmaj.ca/ lookup/doi/10.1503/cmaj.202893/tab-related-content). Sixteen days after his operation, we stopped jejunostomy feeds...

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Gale Document Number: GALE|A677132931