Patient with severe retching/vomiting develops severe retrosternal pain and pain in the chest with a new pleural effusion on the left, most consistent with Boerhaave syndrome
Key idea: Severe retching can lead to Mallory-Weiss tear (severe hematemesis) and Boerhaave syndrome (severe chest pain with extrapulmonary air)
groovygrinchCan anyone explain why air in the left hemithorax would lead to dullness on percussion? +
jj375@groovygrinch I think its blood in the left hemithorax and not air. I was confused too initially since classic esophageal tear presentation has crepitus and air. However, this one mentions pleural effusion on the left, so I'm thinking blood is filling up left side causing dullness to percussion+1
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