Flashcards in Gastrointestinal Perforation Deck (14):
Is an oesophageal perforation an emergency.
Yes, it is a surgical emergency.
What are some causes of an oesophageal perforation. (5)
OGD (increased risk if dilatation or biopsy performed).
Post-emesis (Boerhaave's syndrome).
What are the symptoms of an oesophageal perforation. (2)
What are the clinical signs of an oesophageal perforation. (3)
Shock (tachycardia, tachypnoea, hypotension).
Surgical emphysema of neck/chest (air in tissues - produces a 'crackling' sensation on palpation and is visible on Xray).
Fever/signs of systemic sepsis will rapidly develop if undiagnosed.
What sort of strictures are most likely to get perforated. (3)
What type of strictures can get perforated when performing an endoscopy. (4)
What is Boerhaave's syndrome.
Spontaneous oesophageal perforation, resulting from forceful vomiting and retching.
Why is shock a clinical features of an oesophageal perforation. (2)
Occurs as the oesophageal-gastric contents enter the mediastinum and thoracic cavity.
What are potential complications of oesophageal perforations. (3)
What is seen on an CXR in a patient with Boerhaave syndrome. (3)
Air in the mediastinum or subcutaneous air.
A pleural effusion may be present.
Why might a pleural effusion be present in a patient with Boerhaave syndrome.
Due to the irritation from the luminal contents.
What is a mallory-weiss tear.
Partial thickness oesophageal laceration caused by forceful retching.
What causes a mallory-weiss tear. (2)
After alcohol consumption.