CTICasesBoerhaave Syndrome (Spontaneous Esophageal Rupture)
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Imaging findings
A patient with acute chest pain showed clear mediastinitis on imaging, with extensive debris, liquid, and gas in the mediastinum, consistent with a rip-roaring rupture. This was diagnosed as Boerhaave syndrome.
Key takeaways
Boerhaave syndrome is a spontaneous, transmural rupture of the esophagus, often resulting from a sudden increase in intraesophageal pressure. It presents acutely with severe chest pain and rapidly leads to fulminant mediastinitis, characterized by extensive mediastinal fluid, debris, and gas. Management can sometimes be conservative with antibiotics, though traditionally it requires surgical intervention.
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