Mallory Weiss Boerhaave Syndrome

Question 1

What is mallory weiss and boerhaave syndrome?

Answer 1

Mallory weiss is characterized by a non penetrating vertical mucosal tear at the gastroesophageal junction caused by a sudden increase in pressure. Alcohol use is heavily linked to this condition due to vomiting.

Question 2

What is Boerhaave syndrome?

Answer 2

Is a more sever and specific form of a mallory weiss tear
Anterior perforation of the esophagus with subsequent esophageal lumen becoming continuous with the mediastinum

Question 3

How do these conditions present?

Answer 3

patient will typically be a heavy alcohol user.
Presents with S/S of upper Gi bleed
hemtamesis with or without melena
history of retching, vomiting, or straining is obtained in about fifty percent of cases
hypovolemeia may be present with significant bleeding

Question 4

What is Hartman’s sign?

Answer 4

Crunching sound heard on auscultation of the mediastinum
possible crepitus with palpation of the chest in Boerhaaves

Question 5

What Iv antibiotics do you give for Boerhaaves?

Answer 5

Ertapenem 1g IV qd until seen by a surgeon.