{"title":"肋间管中的牛奶揭示 Boerhaave 综合征","authors":"Manasa Kuthadi, Surendar Reddy K, Narayana Mood, Alekya Papayagari, Rakesh Gattu","doi":"10.1002/rcr2.70056","DOIUrl":null,"url":null,"abstract":"<p><p>We present an uncommon pathology of Boerhaave's syndrome and its fatal outcome in a 77-year-old man who presented to the emergency room with loss of consciousness and a history of chronic cough that had increased in intensity over the past week. Radiological investigations revealed bilateral pleural effusion, initially pointing to a transudative aetiology. Diagnostic pleural aspiration showed an exudative effusion with high amylase, and an intercostal drainage tube was inserted for the left massive effusion. Contrary to the initial provisional diagnosis, the discovery of ingested milk in the intercostal drainage tube raised suspicion of Boerhaave's syndrome. Around 90% of perforations occur on the left side of the distal oesophagus, presenting as a pleural effusion on the left side. Less than 10% of patients experience bilateral pleural effusions. This patient's clinical presentation, which led to the diagnosis, is of interest. Unfortunately, he eventually lapsed into sepsis and succumbed.</p>","PeriodicalId":45846,"journal":{"name":"Respirology Case Reports","volume":"12 10","pages":"e70056"},"PeriodicalIF":0.8000,"publicationDate":"2024-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11513256/pdf/","citationCount":"0","resultStr":"{\"title\":\"Milk in the intercostal tube: Revealing Boerhaave syndrome.\",\"authors\":\"Manasa Kuthadi, Surendar Reddy K, Narayana Mood, Alekya Papayagari, Rakesh Gattu\",\"doi\":\"10.1002/rcr2.70056\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>We present an uncommon pathology of Boerhaave's syndrome and its fatal outcome in a 77-year-old man who presented to the emergency room with loss of consciousness and a history of chronic cough that had increased in intensity over the past week. Radiological investigations revealed bilateral pleural effusion, initially pointing to a transudative aetiology. Diagnostic pleural aspiration showed an exudative effusion with high amylase, and an intercostal drainage tube was inserted for the left massive effusion. Contrary to the initial provisional diagnosis, the discovery of ingested milk in the intercostal drainage tube raised suspicion of Boerhaave's syndrome. Around 90% of perforations occur on the left side of the distal oesophagus, presenting as a pleural effusion on the left side. Less than 10% of patients experience bilateral pleural effusions. This patient's clinical presentation, which led to the diagnosis, is of interest. Unfortunately, he eventually lapsed into sepsis and succumbed.</p>\",\"PeriodicalId\":45846,\"journal\":{\"name\":\"Respirology Case Reports\",\"volume\":\"12 10\",\"pages\":\"e70056\"},\"PeriodicalIF\":0.8000,\"publicationDate\":\"2024-10-27\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11513256/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Respirology Case Reports\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1002/rcr2.70056\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/10/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q4\",\"JCRName\":\"RESPIRATORY SYSTEM\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Respirology Case Reports","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1002/rcr2.70056","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/10/1 0:00:00","PubModel":"eCollection","JCR":"Q4","JCRName":"RESPIRATORY SYSTEM","Score":null,"Total":0}
Milk in the intercostal tube: Revealing Boerhaave syndrome.
We present an uncommon pathology of Boerhaave's syndrome and its fatal outcome in a 77-year-old man who presented to the emergency room with loss of consciousness and a history of chronic cough that had increased in intensity over the past week. Radiological investigations revealed bilateral pleural effusion, initially pointing to a transudative aetiology. Diagnostic pleural aspiration showed an exudative effusion with high amylase, and an intercostal drainage tube was inserted for the left massive effusion. Contrary to the initial provisional diagnosis, the discovery of ingested milk in the intercostal drainage tube raised suspicion of Boerhaave's syndrome. Around 90% of perforations occur on the left side of the distal oesophagus, presenting as a pleural effusion on the left side. Less than 10% of patients experience bilateral pleural effusions. This patient's clinical presentation, which led to the diagnosis, is of interest. Unfortunately, he eventually lapsed into sepsis and succumbed.
期刊介绍:
Respirology Case Reports is an open-access online journal dedicated to the publication of original clinical case reports, case series, clinical images and clinical videos in all fields of respiratory medicine. The Journal encourages the international exchange between clinicians and researchers of experiences in diagnosing and treating uncommon diseases or diseases with unusual presentations. All manuscripts are peer-reviewed through a streamlined process that aims at providing a rapid turnaround time from submission to publication.