Vomiting in pregnancy resulting in oesophageal perforation in a 15-year-old

Woolford, T. J.; Birzgalis, A. R.; Lundell, Caroline J.; Farrington, W. T.

doi:10.1017/s0022215100125289

Cited by 30 publications

(23 citation statements)

References 10 publications

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“…Other events outside pregnancy reported in association with this syndrome include forceful coughing, related to bronchospasm in asthma, and vomiting. 4 The syndrome is also associated with inhalational drug use in which the user performs forceful Valsalva to enhance the drug effect. 5 The case reported here had no history of asthma or respiratory infection or severe vomiting during labour.…”

Section: Discussionmentioning

confidence: 99%

Postpartum spontaneous pneumomediastinum and subcutaneous emphysema: Hamman's syndrome

Kuruba

Hla

2011

Obstet Med

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Summary: This is a case report of a spontaneous pneumomediastinum and surgical emphysema in a 32-year-old woman presenting a few hours after forceps vaginal delivery with symptoms of chest tightness, shortness of breath and swelling in the neck, which resolved with conservative management. It is a rare but potentially dangerous complication of labour, which can be accurately diagnosed with clinical features and chest X-ray. The treatment is conservative as it is usually self-limiting and recurrence in subsequent pregnancies is extremely rare.Keywords: high-risk pregnancy, thoracic medicine, pneumomediastinum CASE REPORTA 32-year-old fit and well Caucasian woman with an uneventful pregnancy presented in spontaneous labour at 40 weeks. This was her second pregnancy and the previous was a miscarriage at eight weeks. She was a non-smoker and her body mass index was 23. The progress in the first stage was good and lasted 10 hours. She had an epidural for analgesia and after one hour of passive descent started pushing. The baby weighing 4.2 kg was delivered by forceps due to failure to progress after 1 and a 1/2 hours of pushing.Twelve hours after delivery, she reported swelling in the neck, chest tightness and shortness of breath. Her vital signs were stable and oxygen saturation on air was 98%. On examination, there was subcutaneous crepitus in the neck and chest. Chest auscultation revealed bilateral decreased air entry. Chest X-ray was performed which showed pneumomediastinum and minimal pneumothorax (Figure 1). She was reviewed by the medical team and a diagnosis of Hamman's syndrome was made. She was managed conservatively and the symptoms slowly settled over the next two days. Subcutaneous emphysema continued to resolve and repeat chest X-ray after 72 hours revealed resolving pneumomediastinum. She was discharged home with no other postpartum problems. The six-week postnatal check showed complete resolution of subcutaneous emphysema.

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Section: Discussionmentioning

confidence: 99%

Postpartum spontaneous pneumomediastinum and subcutaneous emphysema: Hamman's syndrome

Kuruba

Hla

2011

Obstet Med

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“…Boerhaave syndrome is uncommon in children. 2 Esophageal rupture secondary to increased intra-abdominal pressure usually results from violent retching and vomiting but can also occur due to straining, severe coughing, asthma attack, defecation, seizures, childbirth, 3 or even with forceful nose blowing. 4 Boerhaave syndrome should be differentiated from Mallory-Weis syndrome, which involves longitudinal tears on the lower esophageal mucosa, whereas in BS, the rupture is transmural in nature.…”

Section: Discussionmentioning

confidence: 99%

Boerhaave Syndrome-Unusual Cause of Chest Pain

Kundra

Yousaf

Maqbool

et al. 2007

Pediatric Emergency Care

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Spontaneous esophageal rupture (Boerhaave syndrome) is uncommon in children. Delayed or missed diagnosis can lead to poor outcomes in terms of morbidity and mortality. To highlight the importance of early recognition and management of spontaneous esophageal rupture in children, we report a case of a 16-year-old boy who presented in the emergency department with acute chest pain after episodes of vomiting.

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“…In contrast, cases of esophageal rupture accompanying vomiting due to hyperemesis gravidarum have also been reported occasionally (Table 2) [15][16][17][18][19][20][21]. These cases are thought to have been caused by a rise in esophageal pressure during vomiting.…”

Section: Discussionmentioning

confidence: 99%

Severe long esophageal stricture following hyperemesis gravidarum

et al. 2006

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We report a 32-year-old female patient with esophageal stricture thought to have been caused by hyperemesis gravidarum. Eleven months before admission she had been admitted to another hospital, because of hyperemesis gravidarum, at 26 weeks of gestation. Marked and recurrent vomiting occurred and her consciousness gradually worsened. Three weeks later, her baby was delivered by Cesarean section. Postpartum progress was uneventful except that she developed dysphagia 5 months after delivery. Esophagography and upper endoscopy demonstrated severe esophageal stricture. Endoscopic balloon dilatation was performed four times, but was unsuccessful. Blunt dissection of the esophagus was then performed. Histological examination demonstrated marked fibrosis in the submucosal layer and muscular hypertrophy. Esophageal glands were not identified. In this case, esophageal stricture might have been associated with severe esophagitis due to recurrent vomiting and reflux of gastric contents during hyperemesis gravidarum.

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Vomiting in pregnancy resulting in oesophageal perforation in a 15-year-old

Cited by 30 publications

References 10 publications

Postpartum spontaneous pneumomediastinum and subcutaneous emphysema: Hamman's syndrome

Postpartum spontaneous pneumomediastinum and subcutaneous emphysema: Hamman's syndrome

Boerhaave Syndrome-Unusual Cause of Chest Pain

Severe long esophageal stricture following hyperemesis gravidarum

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