Mallory Weiss tear vs Boerhaave

5 Major Difference between Mallory Weiss tear vs Boerhaave syndrome

Mallory-weiss tear vs Boerhaave syndrome
Mallory-weiss tear vs Boerhaave syndrome

Key features of Boerhaave syndrome

  • The classic presentation is an episode of retching or vomiting followed by severe retrosternal pain and/or epigastric pain. So, it is important to distinguish Mallory Weiss tear vs Boerhaave syndrome
  • History of alcohol intake is obtained in 40% of patients.
  • During a physical evaluation, it is important to look for subcutaneous emphysema, which may be absent in 10% to 30% of patients.
  • Other common symptoms and signs include dyspnoea, tachypnoea, cyanosis, sepsis, and shock
  • Conventional radiography of the chest may reveal free mediastinal, peritoneal, or prevertebral air.
  • Pleural effusion, with or without pneumothorax, widened mediastinum, and subcutaneous emphysema may be seen in late presentations.
  • Pleural fluid amylase measurement is indicative of oesophageal rupture.
  • Confirmatory tests include the following:
    • Water-soluble contrast (Gastrografin), which is helpful to localise the lesion.
    • CT scan may also be used as a confirmatory test, and findings include oesophageal wall oedema, peri-oesophageal fluid with or without bubbles, and widened mediastinum

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