Watch what you eat: Man eats dubious street food—ends up blowing apart his GI tract
A 59-year-old man in China had a near-fatal experience after consuming questionable street food. The exact nature of the food is unclear, but it’s certain that he will never have it again. Shortly after ingestion, his internal organs reacted violently. According to a recent case study published in the New England Journal of Medicine, the individual vomited with such force that his esophagus, the muscular tube connecting the throat to the stomach, ruptured.
Boerhaave syndrome is a rare and life-threatening condition characterized by a spontaneous rupture of the esophagus due to severe vomiting or retching. If left untreated within 12-24 hours, mortality rates can range from 60% to 100%. This condition is often underreported, with an estimated incidence of three cases per million people globally each year.
Medical Condition: Boerhaave Syndrome
Boerhaave syndrome is a serious medical condition that requires immediate attention. It occurs when the esophagus suddenly tears due to intense vomiting or retching. The esophagus has muscular layers that contract and relax to propel food into the stomach. In severe cases, the esophageal muscles can fail, causing the esophagus to rupture.
The exact cause of Boerhaave syndrome is not well understood, but researchers believe it may be related to a loss of neuromuscular coordination in the upper sphincter of the esophagus. This leads to a failure to relax during vomiting, resulting in a sudden and intense increase in internal pressure that overwhelms the esophagus.
Case Study: The Chinese Man’s Experience
A recent case study published in the New England Journal of Medicine details the experience of a 59-year-old man who suffered from Boerhaave syndrome after consuming dubious street food. The man presented at the emergency department five and a half hours after experiencing severe vomiting. He was experiencing chest pain while inhaling and exhaling, with fast and shallow breathing sounds in his neck.
Doctors noted that his breath was fast and shallow, with crackling in his neck. Breathing sounds from the base of his right lung were quiet, indicating potential complications. A computed tomography (CT) scan revealed air in his chest space and into his neck, fluid buildup around his lungs, and a collapsing right lung.
The CT scan also showed a perforation in the esophagus, indicating a severe tear. The doctors inserted a chest tube to remove the fluid, which did not include gastric contents, suggesting that the fluid build-up was from chest inflammation.
Diagnostic Tests
To confirm the diagnosis of Boerhaave syndrome, doctors performed additional diagnostic tests. A water-soluble contrast agent was used to examine the esophagus through an X-ray exam. This revealed a large gash in the man’s esophagus resulting from the robust eruption. The imaging also showed the contrast agent leaking out into the man’s chest.
The diagnosis of Boerhaave syndrome is often confirmed through a combination of physical examination, laboratory tests, and imaging studies such as CT scans or X-rays. A prompt and accurate diagnosis is essential to prevent further complications and ensure effective treatment.
Treatment Options
Treatment for Boerhaave syndrome typically involves emergency surgery to repair the damaged esophagus. In severe cases, a feeding tube may be inserted to provide nutrition and hydration while the patient recovers. The man in the case study underwent emergency surgery and spent 35 days in the hospital recovering. When discharged, he still had a feeding tube that passed through his nose and into his small intestine.
It took an additional three months for the perforation to completely heal, at which point doctors could finally remove the feeding tube. The patient’s experience highlights the importance of prompt medical attention and proper treatment for Boerhaave syndrome.
Prevention and Awareness
While the exact cause of Boerhaave syndrome is not well understood, researchers suggest that it may be related to a loss of neuromuscular coordination in the upper sphincter of the esophagus. To prevent this condition, individuals can take steps to maintain good digestive health through a balanced diet, regular exercise, and stress management.
Awareness about Boerhaave syndrome is crucial for early detection and treatment. Healthcare providers should be aware of the symptoms and diagnostic criteria for this condition to provide prompt medical attention. Patients with severe vomiting or retching should seek immediate medical attention if they experience chest pain, difficulty breathing, or other concerning symptoms.
Conclusion
Boerhaave syndrome is a rare and life-threatening condition that requires immediate attention. Prompt diagnosis and treatment can prevent further complications and ensure effective recovery. Awareness about this condition is essential for early detection and treatment. By understanding the causes, symptoms, and diagnostic criteria for Boerhaave syndrome, individuals can take steps to maintain good digestive health and seek medical attention when necessary.
Boerhaave syndrome highlights the importance of maintaining good health through a balanced lifestyle and seeking prompt medical attention when needed. Healthcare providers should be aware of this condition and its diagnostic criteria to provide effective treatment. By working together, we can improve awareness and reduce the incidence of Boerhaave syndrome worldwide.