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Esophageal rupture, also known as Boerhaave syndrome, is a rupture of the esophageal wall. Iatrogenic causes account for approximately 56% of esophageal perforations, usually due to medical instrumentation such as an endoscopy or paraesophageal surgery. [1] The 10% of esophageal perforations caused specifically by vomiting are termed Boerhaave ...
Gastrointestinal perforation, also known as gastrointestinal rupture, [1] is a hole in the wall of the gastrointestinal tract. The gastrointestinal tract is composed of hollow digestive organs leading from the mouth to the anus. [3] Symptoms of gastrointestinal perforation commonly include severe abdominal pain, nausea, and vomiting. [2]
Esophageal perforation can arise from vomiting, incidental trauma from a procedure or operation, external trauma, ingestion of corrosive substances, malignancy, or other esophageal disease. [ 1 ] Other causes of acute mediastinitis include infection secondary to cervical disease which arises from dental procedures, skin infections of the neck ...
Often blood transfusions are not recommended unless the hemoglobin is less than 70 or 80 g/L. [7] [12] Treatment with proton pump inhibitors, octreotide, and antibiotics may be considered in certain cases. [5] [6] [13] If other measures are not effective, an esophageal balloon may be attempted in those with presumed esophageal varices. [2]
In most cases of perforation of a hollow viscus, mixed bacteria are isolated; the most common agents include Gram-negative bacilli (e.g., Escherichia coli) and anaerobic bacteria (e.g., Bacteroides fragilis). Faecal peritonitis results from the presence of faeces in the peritoneal cavity.
Posterior gastric wall perforation may lead to bleeding due to the involvement of gastroduodenal artery that lies posterior to the first part of the duodenum. [22] The death rate in this case is 20%. [15] Penetration is a form of perforation in which the hole leads to and the ulcer continues into adjacent organs such as the liver and pancreas. [16]
The main risks are infection, over-sedation, perforation, or a tear of the stomach or esophagus lining and bleeding. [10] Although perforation generally requires surgery, certain cases may be treated with antibiotics and intravenous fluids. Bleeding may occur at the site of a biopsy or polyp removal.
A perforated ulcer can be grouped into a stercoral perforation which involves a number of different things that cause perforation of the intestine wall. The first symptom of a perforated peptic ulcer is usually sudden, severe, sharp pain in the abdomen. [1] The pain is typically at its maximum immediately and persists.