Esophageal perforation: Difference between revisions
(Created page with "==Causes== #Iatrogenic #Boerhaave syndrome #Trauma ##Penetrating ##Blunt (rare) #Caustic ingestion #Foreign body (includes pill esophagitis) #Infection (rare) #Tumor #Aortic path...") |
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#Infection (rare) | #Infection (rare) | ||
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Revision as of 00:41, 1 August 2011
Causes
- Iatrogenic
- Boerhaave syndrome
- Trauma
- Penetrating
- Blunt (rare)
- Caustic ingestion
- Foreign body
- Bone, button battery
- Infection (rare)
- Tumor
- Aortic pathology
- Barrett esophagus
- Zollinger-Ellison syndrome
Diagnosis
History
- Pain
- Acute, severe, unrelenting, diffuse
- May be localized to chest, neck, abdomen; radiate to back and shoulders
- Dysphagia
- Dyspnea
- Hematemesis
Physical Exam
- Cervical subcutaenous emphysema
- Mediastinal emphysema
- Takes time to develop
- Absence does not rule out perforation
Imaging
- CXR
- CT chest
- Emergent endoscopy
DDx
- ACS
- PE
- Aortic catastrophe
- Acute abdomen
- Peptic ulcer disease
Treatment
- Volume resuscitation
- Broad-spectrum IV Abx
- Emergent surgical consultation
Disposition
See Also
Source
Tintinalli