Flashcards in Oesophageal Perforation Deck (6):
1
What is an Oesophageal rupture?
Oesophageal Rupture is a transmural tear of the oesophageal wall, Boerhaave’s syndrome is an oesophageal rupture due to vomiting. It is different from Mallory Weiss tear which is only a tear of the mucosa.
2
What are the causes of Oesophageal rupture?
Trauma, Vomiting (Commonly alcohol or bulimia), Corrosive Ingestion, Oesophageal Carcinoma, Iatrogenic (Endoscopy, Biopsy)
3
What will you find on a history taking of Oesophageal rupture?
Symptoms:
Triad of vomiting, chest pain and subcutaneous emphysema
Patient will be very ill – Hypotensive, Shock, Near Death
Risk Factors:
Recent Iatrogenic procedure
Recurrent Vomiting
4
What will you find on a examination of Oesophageal rupture?
End of the bed:
Fever - Rupture goes onto cause mediastinitis or sepsis
Neck
Surgical Emphysema
Chest:
Surgical Emphysema
Tachypnoea
Dyspnoea
Hypotension
Listen for a pleural effusion
5
What investigations will you order in an Oesophageal rupture?
Bedside:
Full set of Observations
ECG – They are very ill and Pre-operative workup
Bloods:
FBC - Anaemia if bleeding, infection if mediastinitis
U&E - May need surgery and looking for dehydration due to bleed
LFT – Pre-Operative Bloods
Imaging:
CXR – Looking for enlarged mediastinum and for any pleural effusion that can occur
CT – Identifying the rupture, may not have time for this
6