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Arch Emerg Med. 1993 December; 10(4): 310–313.
PMCID: PMC1286039

Oesophageal perforation: an unusual complication of a hypoglycaemic episode.


A case of spontaneous oesophageal rupture following vomiting, secondary to a hypoglycaemic episode is reported. The case is of interest in its presentation and physical signs. It reflects the difficulty in diagnosing a condition associated with considerable morbidity and mortality. The importance of recognition of a pattern of symptoms, physical signs and radiographic findings is emphasized.

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Selected References

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  • Abbott OA, Mansour KA, Logan WD, Jr, Hatcher CR, Jr, Symbas PN. Atraumatic so-called "spontaneous" rupture of the esophagus. A review of 47 personal cases with comments on a new method of surgical therapy. J Thorac Cardiovasc Surg. 1970 Jan;59(1):67–83. [PubMed]
  • Granich MS, Klotz RE, Lofgren RH, Partlow RC, Jr, DiGregorio LI. Spontaneous retropharyngeal and cervical subcutaneous emphysema in adults. Arch Otolaryngol. 1983 Oct;109(10):701–704. [PubMed]
  • Patton AS, Lawson DW, Shannon JM, Risley TS, Bixby FE. Reevaluation of the Boerhaave syndrome. A review of fourteen cases. Am J Surg. 1979 Apr;137(4):560–565. [PubMed]
  • Rogers LF, Puig AW, Dooley BN, Cuello L. Diagnostic considerations in mediastinal emphysema: a pathophysiologic-roentgenologic approach to Boerhaave's syndrome and spontaneous pneumomediastinum. Am J Roentgenol Radium Ther Nucl Med. 1972 Jul;115(3):495–511. [PubMed]
  • Walker WS, Cameron EW, Walbaum PR. Diagnosis and management of spontaneous transmural rupture of the oesophagus (Boerhaave's syndrome). Br J Surg. 1985 Mar;72(3):204–207. [PubMed]

Articles from Archives of Emergency Medicine are provided here courtesy of BMJ Publishing Group