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Ruptured celiac artery aneurysm mimicking Boerhaave syndrome.

Ruptured celiac artery aneurysm is a rare cause for epigastric pain and is usually detected incidentally. Atypical presentation with postemetic epigastralgia and pleural effusion usually leads physicians to make the diagnosis of Boerhaave syndrome. Herein, we report a 32-year-old woman who was diagn... Full description

Journal Title: The American journal of emergency medicine September 2013, Vol.31(9), pp.1421.e5-6
Main Author: Liu, Chien-Yu
Other Authors: Yang, Kai-Wei , Chen, Wei-Kung , Huang, Chen-Hsiung
Format: Electronic Article Electronic Article
Language: English
Subjects:
ID: E-ISSN: 1532-8171 ; DOI: 1532-8171 ; DOI: 10.1016/j.ajem.2013.05.014
Link: http://search.proquest.com/docview/1431627649/?pq-origsite=primo
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title: Ruptured celiac artery aneurysm mimicking Boerhaave syndrome.
format: Article
creator:
  • Liu, Chien-Yu
  • Yang, Kai-Wei
  • Chen, Wei-Kung
  • Huang, Chen-Hsiung
subjects:
  • Abdominal Pain–Diagnosis
  • Adult–Etiology
  • Aneurysm, Ruptured–Complications
  • Celiac Artery–Diagnosis
  • Diagnosis, Differential–Diagnostic Imaging
  • Emergency Service, Hospital–Diagnostic Imaging
  • Esophageal Perforation–Diagnosis
  • Female–Diagnosis
  • Humans–Etiology
  • Mediastinal Diseases–Etiology
  • Pleural Effusion–Etiology
  • Tomography, X-Ray Computed–Etiology
ispartof: The American journal of emergency medicine, September 2013, Vol.31(9), pp.1421.e5-6
description: Ruptured celiac artery aneurysm is a rare cause for epigastric pain and is usually detected incidentally. Atypical presentation with postemetic epigastralgia and pleural effusion usually leads physicians to make the diagnosis of Boerhaave syndrome. Herein, we report a 32-year-old woman who was diagnosed with Boerhaave syndrome initially after presenting with acute postemetic epigastralgia and predominant left side pleural effusion. Diagnostic left thoracentesis yielded bloody fluid with similar amylase level to serum. The chest computed tomographic scan showed no evidence of esophageal rupture. However, a ruptured celiac artery aneurysm with retroperitoneal hematoma extending to the posterior mediastinum and bilateral pleural space was found incidentally. Although ruptured celiac artery aneurysm is an uncommon cause for postemetic epigastralgia, acute vascular events such as the previously stated cause should be the first impression rather than Boerhaave syndrome if the patient also presents with isolated pleural effusion containing unelevated amylase.
language: eng
source:
identifier: E-ISSN: 1532-8171 ; DOI: 1532-8171 ; DOI: 10.1016/j.ajem.2013.05.014
fulltext: fulltext
issn:
  • 15328171
  • 1532-8171
url: Link


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titleRuptured celiac artery aneurysm mimicking Boerhaave syndrome.
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subjectAbdominal Pain–Diagnosis ; Adult–Etiology ; Aneurysm, Ruptured–Complications ; Celiac Artery–Diagnosis ; Diagnosis, Differential–Diagnostic Imaging ; Emergency Service, Hospital–Diagnostic Imaging ; Esophageal Perforation–Diagnosis ; Female–Diagnosis ; Humans–Etiology ; Mediastinal Diseases–Etiology ; Pleural Effusion–Etiology ; Tomography, X-Ray Computed–Etiology
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descriptionRuptured celiac artery aneurysm is a rare cause for epigastric pain and is usually detected incidentally. Atypical presentation with postemetic epigastralgia and pleural effusion usually leads physicians to make the diagnosis of Boerhaave syndrome. Herein, we report a 32-year-old woman who was diagnosed with Boerhaave syndrome initially after presenting with acute postemetic epigastralgia and predominant left side pleural effusion. Diagnostic left thoracentesis yielded bloody fluid with similar amylase level to serum. The chest computed tomographic scan showed no evidence of esophageal rupture. However, a ruptured celiac artery aneurysm with retroperitoneal hematoma extending to the posterior mediastinum and bilateral pleural space was found incidentally. Although ruptured celiac artery aneurysm is an uncommon cause for postemetic epigastralgia, acute vascular events such as the previously stated cause should be the first impression rather than Boerhaave syndrome if the patient also presents with isolated pleural effusion containing unelevated amylase.
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