• Join
  • Store
  • Calendar
  • My Profile
  • Get AMSA ID
  • User Login
AMSA-Logo-w-tagline-mediumAMSA-Logo-w-tagline-mediumAMSA-Logo-w-tagline-mediumAMSA-Logo-w-tagline-medium
  • Member Center
    • Deals & Offers
    • Renew or Join
    • AMSA Around the World
    • Chapter Officer Hub
    • Launch Pad
    • Start a Chapter
    • What’s On
  • Programs & Events
    • Clinical Experiences Program
    • Convention & Exposition
    • HEART-IM Elective
    • IMG Residency Prep Series
    • Leadership Program
    • Med School Success Series
    • Mentorship Program
    • PremedFest
    • Regional SIM Challenges
    • Reproductive Health Project
    • Residency Prep Program
    • Self Awareness Assessment
    • Scholars Programs
  • Get Involved
    • AMSA Activism Updates
    • Action Committees
    • Campaigns & Initiatives
    • COVID-19 Medical Student Resources
    • Fellowship Program
    • House of Delegates
    • Leadership Opportunities
    • Weeks of Action
    • Alumni
  • News & Resources
    • AMSA Alliance Directory
    • The New Physician magazine
    • On Call Blog
    • Weekly Consult newsletter
    • AMSA Ad Lib Podcast
    • Press Room
  • About
    • How AMSA Works
    • Why AMSA?
    • Advisory Council
    • AMSA Foundation
    • Constitution & Bylaws
    • National Leadership
    • National Office Staff
    • Our History
How can medical trainees make medicines more affordable?
February 12, 2019
What’s causing this patient’s seizures?
March 6, 2019
Show all

A drinking binge leads to a surgical emergency

Figure 1 Quiz of the Week

A 58-year-old male presents to the emergency department with dyspnea, and severe chest pain that radiates to his shoulder. He has a history of alcoholism and has just finished a 4-day drinking binge. On examination, crepitus is heard on palpation of the chest wall, and his pain worsens as he swallows. A diagnosis of Boerhaave syndrome is suspected and thoracentesis drains 800 ml of brown liquid.

What is the most common site of esophageal perforation?


View Results
Loading ... Loading ...

 

Image credit: @G3KR.


Answer: Left posterolateral aspect of distal intrathoracic esophagus

This patient has Boerhaave syndrome, a perforation of the esophagus. It is caused by a combination of increased intraesophageal pressure and negative intrathoracic pressure associated with vomiting. The most common site of perforation is the left posterolateral aspect of the distal intrathoracic esophagus. Rupture of this area contaminates the mediastinal cavity with gastric contents, usually resulting in a left-sided hydropneumothorax. Perforation of the midesophagus typically produces a pleural reaction in the right hemithorax.

Read more and join the discussion now at Figure 1!


Explore cases, quiz yourself, and solve medical mysteries along with thousands of other medical professionals around the world on Figure 1, the free app where doctors expand their clinical knowledge.

Share

Related posts

March 6, 2019

What’s causing this patient’s seizures?


Read more
February 6, 2019

Which additional CSF finding is most likely?


Read more
January 30, 2019

What audible finding is consistent with this presentation?


Read more

Leave a Reply Cancel reply

Your email address will not be published. Required fields are marked *

  • Join / Renew Membership
  • AMSA Foundation
  • Online Store
  • Press Room
  • Work With Us
  • Institutional Partners

Contact Us

Follow Us




Copyright 2019, American Medical Student Association, Chantilly, VA