An autopsy case of spontaneous esophageal perforation (Boerhaave syndrome)

作者：Kimura Kataoka Kaori^*; Fujihara Junko; Kurata Satsuki; Takinami Yoshikazu; Inoue Ken; Yasuda Toshihiro; Takeshita Haruo

来源：Legal Medicine, 2016, 23: 5-9.

DOI：10.1016/j.legalmed.2016.08.009

• Boerhaave syndrome
• Spontaneous esophageal perforation
• Forensic autopsy
• Alcoholism

A 45-year-old male, an alcohol addict with asthma, was found dead in his home, after several days of continued drinking. A forensic autopsy was performed 3 days after the discovery of his death in order to specify the cause of death.
A longitudinal perforation penetrating all layers of the esophagus measuring 1.8 cm was present on the left wall approximately 2.0 cm from the gastroesophageal junction. There were 1900 mL of greenish to brownish turbid liquid in the left pleural cavity and 150 mL of greenish viscous liquid in the stomach. Histopathologically, an infiltration of numerous neutrophils was evident in the submucosa layer, proper muscular layer, and serous membrane of the esophagus, corresponding to the esophageal laceration. The serum C-reactive protein (CRP) concentration was determined to be 3.1 mg/dL. The alcohol concentrations were determined to be 1.49 mgig in the right cardiac blood, 1.31 mgig in the left cardiac blood, and 2.48 mg/g in urine.
Based upon the autopsy and histopathological findings, as well as the biochemical and toxicological analyses, we concluded that the cause of death was respiratory failure by pleural effusion, resulting from spontaneous esophageal perforation. This was the first report of a spontaneous esophageal perforation eventually causing respiratory failure.

• 出版日期2016-11