Painless esophageal rupture in the second stage of labor presenting as surgical emphysema of the neck: a case report
Abstract Background Pneumomediastinum in pregnancy has been described in around 200 cases, with an incidence of 1:100,000 pregnancies. The etiology is presumed to be either alveolar barotrauma secondary to the Valsalva maneuver (Hamman’s syndrome) during the second stage of labor, or spontaneous eso...
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| Language: | English |
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BMC
2025-02-01
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| Series: | Journal of Medical Case Reports |
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| Online Access: | https://doi.org/10.1186/s13256-024-05008-x |
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| author | Thomas Hussey Serena Banh Stavroula L. Kastora Hemant Vakharia |
| author_facet | Thomas Hussey Serena Banh Stavroula L. Kastora Hemant Vakharia |
| author_sort | Thomas Hussey |
| collection | DOAJ |
| description | Abstract Background Pneumomediastinum in pregnancy has been described in around 200 cases, with an incidence of 1:100,000 pregnancies. The etiology is presumed to be either alveolar barotrauma secondary to the Valsalva maneuver (Hamman’s syndrome) during the second stage of labor, or spontaneous esophageal rupture (Boerhaave’s syndrome). The latter has a much higher morbidity/mortality and classically arises from esophageal rupture during excessive vomiting. Boerhaave’s syndrome is described as a triad of chest pain, vomiting, and surgical emphysema, though all symptoms are seen in only one-third of cases. The majority of reported obstetric cases originate from vomiting in early pregnancy with patients clinically unwell, presenting with acute severe chest pain and shortness of breath. Case presentation We present a case of esophageal rupture in a 24-year-old Eastern European primigravida, presenting postnatally with neck emphysema in the absence of significant chest pain or other symptoms. Conclusion The diagnosis of Boerhaave’s syndrome is often delayed, and a high index of clinical suspicion is required to reach a timely diagnosis. |
| format | Article |
| id | doaj-art-9878828e19934c99836d935257ddbd6d |
| institution | Kabale University |
| issn | 1752-1947 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Medical Case Reports |
| spelling | doaj-art-9878828e19934c99836d935257ddbd6d2025-02-09T12:38:32ZengBMCJournal of Medical Case Reports1752-19472025-02-011911310.1186/s13256-024-05008-xPainless esophageal rupture in the second stage of labor presenting as surgical emphysema of the neck: a case reportThomas Hussey0Serena Banh1Stavroula L. Kastora2Hemant Vakharia3Department of Gynaecological Oncology London, University College London Hospitals NHS Foundation TrustBarking, Havering and Redbridge University Hospitals NHS Foundation TrustDepartment of Gynaecological Oncology London, University College London Hospitals NHS Foundation TrustRoyal Free NHS Foundation TrustAbstract Background Pneumomediastinum in pregnancy has been described in around 200 cases, with an incidence of 1:100,000 pregnancies. The etiology is presumed to be either alveolar barotrauma secondary to the Valsalva maneuver (Hamman’s syndrome) during the second stage of labor, or spontaneous esophageal rupture (Boerhaave’s syndrome). The latter has a much higher morbidity/mortality and classically arises from esophageal rupture during excessive vomiting. Boerhaave’s syndrome is described as a triad of chest pain, vomiting, and surgical emphysema, though all symptoms are seen in only one-third of cases. The majority of reported obstetric cases originate from vomiting in early pregnancy with patients clinically unwell, presenting with acute severe chest pain and shortness of breath. Case presentation We present a case of esophageal rupture in a 24-year-old Eastern European primigravida, presenting postnatally with neck emphysema in the absence of significant chest pain or other symptoms. Conclusion The diagnosis of Boerhaave’s syndrome is often delayed, and a high index of clinical suspicion is required to reach a timely diagnosis.https://doi.org/10.1186/s13256-024-05008-xBoerhaave’s syndromeHamman’s syndromeEsophageal rupturePneumomediastinumSurgical emphysema |
| spellingShingle | Thomas Hussey Serena Banh Stavroula L. Kastora Hemant Vakharia Painless esophageal rupture in the second stage of labor presenting as surgical emphysema of the neck: a case report Journal of Medical Case Reports Boerhaave’s syndrome Hamman’s syndrome Esophageal rupture Pneumomediastinum Surgical emphysema |
| title | Painless esophageal rupture in the second stage of labor presenting as surgical emphysema of the neck: a case report |
| title_full | Painless esophageal rupture in the second stage of labor presenting as surgical emphysema of the neck: a case report |
| title_fullStr | Painless esophageal rupture in the second stage of labor presenting as surgical emphysema of the neck: a case report |
| title_full_unstemmed | Painless esophageal rupture in the second stage of labor presenting as surgical emphysema of the neck: a case report |
| title_short | Painless esophageal rupture in the second stage of labor presenting as surgical emphysema of the neck: a case report |
| title_sort | painless esophageal rupture in the second stage of labor presenting as surgical emphysema of the neck a case report |
| topic | Boerhaave’s syndrome Hamman’s syndrome Esophageal rupture Pneumomediastinum Surgical emphysema |
| url | https://doi.org/10.1186/s13256-024-05008-x |
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