ABSTRACT
Boerhaave's syndrome is a spontaneous transmural rupture or perforation of the oesophagus or post-emesis oesophageal rupture. Boerhaave's syndrome has a high risk of morbidity and mortality, and early, definitive diagnosis leading to prompt management improves outcomes. Definitive diagnosis of this syndrome is made with imaging, including x-ray, USG and computed tomography Scan. This is a case of a 50-year male with history of sudden onset of epigastric pain after an episode of forceful emesis was referred for Ultrasound (USG) abdomen. His USG examination demonstrated fluid collection with internal free floating and linear echoes in left pleural cavity consistent with hemo-pneumothorax his further imaging workup was done with suspicious of Boerhaave's Syndrome which conformed the suspected diagnosis.
Subject(s)
Esophageal Perforation/diagnostic imaging , Mediastinal Diseases/diagnostic imaging , Abdominal Pain/diagnostic imaging , Abdominal Pain/etiology , Early Diagnosis , Esophageal Perforation/complications , Humans , Male , Mediastinal Diseases/complications , Middle Aged , Multimodal Imaging , Pneumothorax/diagnostic imaging , Pneumothorax/etiology , Radiography , Rupture, Spontaneous , Tomography, X-Ray Computed , Vomiting/diagnostic imaging , Vomiting/etiologyABSTRACT
A 25-year old pregnant female with history of confusion and drowsiness for 02 days was referred by neurophysician for MRI brain. MRI demonstrated T2W/FLAIR hyper intensities in medial thalami, periaqueductal areas with variable diffusion restriction, apparent as hyper intense signal on DWI and no signal change on ADC mapping that was typically consistent with Wernicke's encephalopathy. A high index of suspicion is necessary, as delayed or lack of treatment can lead to high morbidity and mortality.
