5 Major Difference between 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