Boerhaave 증후군의 내시경적 소견 3예

Abstract

Boerhaave's syndrome, which was first described by Herman Boerhave in 1724, is a spontaneous esophagcal rupture resulting from severe nausea and vomiting. It is a very rare disorder, frequently developed in the 4th to 6th decade of life, and affects males more commonly than females. A typical clinical triad of chest pain, fever, and subcutaneous emphysema was manifested in only 20-30% of cases involving an esophageal rupture and most patients complained of many nonspecific symptoms such as dyspnea and hematemesis. In cases of vomiting resulting from alcohol ingestion, gastrofiberscopy can be performed in hematemetic patients under the assumption of upper gastrointestinal bleeding in most cases of Boerhaave's syndrome. We report 3 patients of Boerhaave's syndrome who visited our hospital because of hematemesis. Their endoscopic findings were, 1) a large, deep oval-shaped laceration with a sharp margin on the distal esophagus 2) a cavitary lesion with internal multiple hematomas and/or necrotic debris, and 3) a formation of air bubbles in the hematoma relating to respiration.