Medical image of the week: Boerhaave syndrome

Abstract

No abstract available. Article truncated at 150 words. A 41-year-old woman with a history of gastroesophageal reflux disease (GERD), asthma and iron deficiency anemia presented with complaints of right sided chest pain, nausea and emesis for several days prior to hospital presentation. She had also been experiencing progressive dysphagia to solids for a month preceding admission. CT chest imaging revealed mega-esophagus (Figure 1A) with rupture into the right lung parenchyma and resultant abscess formation (Figure 1B and 1C). A subsequent echocardiogram also confirmed mitral valve endocarditis. An image-guided chest tube was placed in the abscess for drainage. Endoscopy was attempted but visualization was difficult due to the presence of retained food. Given her low albumin and poor nutritional state, a jejunostomy tube was placed. Follow up CT imaging with contrast through a nasogastric tube confirmed extravasation of esophageal contrast into the right lung parenchyma (Figure 1D). Blood and sputum cultures grew Candida glabrata. She was initially started on ...

Keywords

• Boerhaave's syndrome
• Boerhaave
• sydrome
• achalasia
• Candida glabrata
• CT scan
• fungemia
• endocarditis
• treatment
• upper GI series