Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0042963 (vomiting)
 31,883 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A case of spontaneous esophageal rupture (Boerhaave's syndrome) is presented. The patient was referred from an outside hospital emergency department to Los Angeles County/University of Southern California Medical Center with a history of acute left-sided chest pain immediately after an episode of forceful vomiting. An upright chest radiograph revealed a left hydropneumothorax. The diagnosis of Boerhaave's syndrome was confirmed with the placement of a chest tube and extraction of serosanguinous fluid and partially digested food particles from the left hemithorax. The patient underwent surgical repair and was discharged from the hospital in good condition. Boerhaave's syndrome is extremely rare. The predominant symptoms of chest pain and dyspnea also are found in many common disease entities, making early diagnosis difficult. Delay in diagnosis and treatment results in substantial morbidity and mortality. This case exemplifies the importance of obtaining an upright chest radiograph to make a prompt diagnosis.
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PMID:A case of Boerhaave's syndrome presenting as diffuse left pulmonary infiltrate. 195 13

Spontaneous intramural hematoma of the esophagus (SIHE) is a rare condition usually affecting middle-aged or elderly women. It presents as acute substernal or epigastric pain, typically accompanied by dysphagia or hematemesis. SIHE is not usually associated with vomiting, and is therefore clearly distinguishable from hematogenic esophageal disorders, such as the Mallory Weiss lesion and the Boerhaave syndrome. The pathogenesis is in dispute. We present a case of SIHE without a discernible mucosal breach, suggesting a primary intramural bleed as the initiating event. Its diagnosis relies on the history and a barium swallow. Instrumentation can result in further damage to the esophagus. Treatment is conservative and results in resolution of the hematoma and return to normal swallowing. A favorable prognosis is the rule.
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PMID:[A submucosal hematoma of the esophagus. A clinical case]. 215 54

Spontaneous esophageal perforation (Boerhaave syndrome) is a life-threatening emergency. It usually has misleading clinical manifestations and causes severe complications. In the presence of the clinical manifestations: vomiting, pain, emphysema, this diagnosis must be considered and confirmed by radiological evaluation of the chest and the esophagus. We report two cases and we describe the severity of this syndrome, its cause, its pathogenesis, and its characteristic clinical features and radiological signs.
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PMID:[Boerhaave's syndrome]. 222 78

A case of spontaneous oesophageal rupture or Boerhaave syndrome is described. The absence of the typical initial vomiting together with a clinical picture that successively indicated repeated myocardial infarction, pancreatitis and pulmonary abscess delayed diagnosis by 4 days, after which emergency thoracotomy, performed on the identification of extravisceral overflow by contrast radiography using a water-soluble medium, revealed necrotic inflammation of the oesophagus, mediastinum and left lung that was so severe that only thoracic drainage was possible. After an initial improvement the patient died of septic shock on the 16th postoperative day.
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PMID:[Spontaneous esophageal rupture or Boerhaave's syndrome. Presentation of a case]. 233 50

This retrospective review of 34 patients with spontaneous rupture of the esophagus, which spans a 30-year period, attempts to identify areas in diagnosis and therapy that might alter the dismal prognosis. The diagnosis and definitive surgical repair of Boerhaave's syndrome were frequently delayed. Delay resulted in a significant increase in complication rates. Pain (85%) and vomiting (71%) were the only common historical events suggesting the diagnosis. Physical examination was of aid in the diagnosis in only the 9 patients (27%) who demonstrated cervical or mediastinal emphysema. The initial chest roentgenogram was abnormal in 97% of the patients, but was interpreted as "compatible with perforation of the esophagus" in only 27%. Esophagography was diagnostic in 23 of 24 patients in whom it was used. Thoracentesis was of little diagnostic aid, but pleural fluid pH was measured in only 15% of the patients. Prompt surgical repair, regardless of time after onset, appears to be the indicated therapy.
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PMID:Spontaneous rupture of the esophagus: a 30-year experience. 273 Jan 90

A 10-cm-long longitudinal tear in the middle third of the oesophagus--with intact deeper muscle layers--was found endoscopically in a 52-year-old alcoholic man who had developed acute retrosternal pain after severe vomiting. There was a leukocytosis of 16,700/microliters and fever of 38.8 degrees C. Because of the diagnosis of incomplete spontaneous oesophageal rupture (Boerhaave syndrome) he was fed parenterally, a gastric tube was placed, and he received three times daily 2 g ampicillin, twice daily 80 mg gentamicin and 1.2 g cimetidine. The fever disappeared after 24 hours and the leukocytosis regressed after four days. At repeat endoscopy after 16 days the tear had healed completely.
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PMID:[Boerhaave syndrome. The differential diagnosis of acute retrosternal pain]. 275 20

Spontaneous intramural hematoma of the esophagus (SIHE) is a rare condition usually affecting middle-aged or elderly women. It presents as acute substernal or epigastric pain, typically accompanied by dysphagia or hematemesis. SIHE is not usually associated with vomiting, and is therefore clearly distinguished from emetogenic esophageal disorders, such as the Mallory-Weiss lesion and the Boerhaave syndrome. The diagnosis has traditionally been made by barium esophagram. Therapy is conservative; a favorable prognosis is the rule. The pathogenesis is in dispute. We present a case of SIHE without a discernible mucosal breach, suggesting a primary intramural bleed as the initiating event. We document the utility of computed tomographic scan and magnetic resonance imaging in the diagnosis of SIHE.
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PMID:Spontaneous intramural hematoma of the esophagus. 280 87

The Boerhaave syndrome is classically considered a panmural perforation of the distal esophagus secondary to forced vomiting or retching. A variant of the syndrome is described in which only the outer longitudinal muscle layer of the esophagus was torn, and in this case most of the usual radiological findings were absent. The clinical, radiological, and surgical findings are discussed.
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PMID:Computed tomography of mediastinal hematoma secondary to unusual esophageal laceration: a Boerhaave variant. 291 Sep 30

Among the different types of esophageal wall injuries Boerhaave's syndrome is associated with the highest morbidity and mortality. The classical history of retching or vomiting and retrosternal splitting pain is indicative. Roentgenograms of the chest and esophagogram with a water soluble contrast medium are able to reveal the perforation in most cases. Esophagoscopy has been recommended for diagnosis, but its use is unnecessary and frequently contraindicated. Spontaneous perforation of the esophagus should be treated by prompt surgical intervention: left side thoracotomy, direct closure of the perforation by monolayer suture, and adequate mediastinal and pleural drainage. The treatment of esophageal perforation after late diagnosis is considerably more complicated and may consist in a drainage only.
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PMID:[Boerhaave syndrome]. 323 65

Report on a 69-year-old male with spontaneous atraumatic rupture of the oesophagus (Boerhaave's syndrome) in clinically mentioned chronic abuse of alcohol and massive vomiting which preceded the event. Discussion of causes, differential diagnosis, therapy as well as of forensic aspects of this syndrome.
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PMID:[Boerhaave syndrome--atraumatic total esophageal rupture]. 325 57


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