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Old 07-07-2012
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Re: Seasick & Singlehanding

It's a favorite bust your balls question to junior residents but it just doesn't happen very often. And yes often they get mediastinitis as well. I've just never seen it. Only ten percent of esophageal ruptures are from vomiting which is Boorhaves. About 60 percent is iatragenic and the rest like the older man.

I think in Boorhaves the mechanism of injury is excessive intraesophageal pressure with low intrathoracic. I have heard of rupture with vomiting in someone with a stricture.

I'll stop now before I bore people to death.
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