Oussama77
Forum Junior
Topics: 9
Posts: 58
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21. A 67-year-old woman is brought to the emergency department because of severe chest pain 4 hours after undergoing outpatient endoscopy and dilatation of an esophageal stricture caused by reflux. At discharge, she reported no chest pain. Three hours later, she vomited a small amount of blood and had severe pain. She is pale. Her temperature is 38 C (100.4 F), blood pressure is 140/85 mm Hg, pulse is 125/min, and respirations are 22/min. Examination shows crepitus in the neck and moderate epigastric tenderness. The lungs are clear to auscultation, and breath sounds are equal bilaterally. Rectal examination shows no masses; test of the stool for occult blood is positive.
Which of the following is the most likely cause of these symptoms?
A) Bleeding from erosive esophagitis
B) Esophageal perforation
C) Mallory-Weiss syndrome
D) Myocardial infarction
E) Perforated gastric ulcer.
There is crepitus in the neck so I go with, B) Esophageal perforation.
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| wasedf
Forum Junior
Topics: 5
Posts: 74
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I think so too that it is esophageal perforation. Explains the crepitus in the neck 4 hours after the endoscopy.
I wonder why the stool occult test is positive?? Any thoughts?
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| Eagle_303
Forum Guru
Topics: 77
Posts: 655
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Esophageal perforation .
Most common cause of Boerhave is iatrogenic
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| OlgaG
Forum Newbie
Topics: 2
Posts: 23
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I think it is an esophageal perforation. Stool occult is positive because some amount of blood went to stomach and intestine.
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| nightflight1945
banned
Topics: 32
Posts: 920
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B) Esophageal perforation
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| altabban
Forum Newbie
Topics: 2
Posts: 29
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iatrogenic perforation of the esophagus.
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