Department of Intensive Care Medicine, University Hospital of Wales, Cardiff, UK.
Minerva Anestesiol. 2010 Oct;76(10):865-7. Epub 2010 Jul 16.
Boerhaave's syndrome is the rare and often fatal condition of spontaneous esophageal rupture. Meckler's triad of vomiting, pain and subcutaneous emphysema are characteristic features of Boerhaave's syndrome. When these symptoms are absent, diagnosis is frequently late and often occurs as the result of incidental investigation. This contributes to the observed high morbidity and mortality. Unless specifically considered in the differential diagnosis, this rare disease is frequently overlooked. The authors described the case of a patient in whom the diagnosis was made several days following presentation by observing that a large pleural effusion had evolved rapidly on chest radiographs. This uncommon radiological sign has relatively few causes and prompted a review of the history and diagnosis, followed by the initiation of additional investigations that confirmed Boerhaave's syndrome.
布鲁瓦氏综合征是一种罕见且常致命的自发性食管破裂症。梅克尔三联征（呕吐、疼痛和皮下气肿）是布鲁瓦氏综合征的特征性表现。当这些症状不存在时，诊断通常较晚，通常是偶然检查的结果。这导致了观察到的高发病率和死亡率。除非在鉴别诊断中特别考虑，否则这种罕见疾病经常被忽视。作者描述了一位患者的病例，在胸部 X 线片上观察到胸腔积液迅速发展几天后，几天之后才做出诊断。这种不常见的放射学征象相对较少见，促使我们回顾了病史和诊断，随后进行了进一步的检查，证实了布鲁瓦氏综合征的诊断。
