Sorry maybe I misunderstood, but Iatrogenic perforation accounts for 85-90% of all esophageal ruptures, not Boerhaave's S. (source: Medscape and Toronto notes)
Sir, as far as we've been taught here in India----gastrograffin is preferred in intra abdominal perforations as its inert in abdomen and thus does not cause any inflammatory reaction whereas barium is preferred in oesophageal perforation for being inert in the thoracic cavity and not precipitating medaistinitis. please clear my doubt. thank you
No. The issue is with barium entering the blood stream. we really don't want any contact between barium and the extraluminal tissues. Gastrograffin is better because it is inert, but has a lower diagnostic sensitivity and specificity radiologically, so is only used in cases of suspected perforation or risk of perforation. It is also more expensive.
