Saul Allen Mackler (1913-2007) was an American thoracic Surgeon.
Mackler was an Associate Professor of thoracic surgery at Chicago Medical School. He is noted for numerous advancements to the field of thoracic surgery through his work at Michael Reese Hospital and Cook County Hospital, including contributions to the development of the cardiac pacemaker and surgical procedures correcting birth defects in pediatric cardiology
Eponymously remebered for Mackler’s Triad. In 1952 he described his clinical triad of vomiting, thoracic pain and subcutaneous cervical emphysema – as classic signs for oesophageal rupture, unfortunately only present 14-25% of the time.
- Born December 9, 1913 in Brooklyn, New York
- 1943-1946 Major in the US Army; North Africa, Sicily and Northern Italy
- Cardiothoracic surgeon at at Michael Reese Hospital and Cook County Hospital
- Associate Professor of thoracic surgery at Chicago Medical School
- Died on December 1, 2007 in Illinois
Mackler’s triad (1952)
Mackler described the three characteristic features of oesophageal rupture as vomiting, lower thoracic pain (T10) and subcutaneous cervical emphysema. Diagnostic of oesophageal rupture and an indication for left thoracotomy.
Mackler pointed out the difference between rupture and perforation. Rupture is a spontaneous cause or due to indirect trauma likely related to increase intra-abdominal pressure. Mackler supported this with the histopathology of oesophageal ruptures.
Mackler identified the as the weakest part of the oesophageal wall in a cadaveric study. He found that a longitudinal tear in the lower extremity of the oesophagus was uniformly involved. In comparison with perforation in which oval tear if often formed.
- Mackler SA. Experience with thoracic and thoracoabdominal wounds in an evacuation hospital. J Thorac Surg. 1947 Oct;16(5):538-70.
- Mackler SA. Spontaneous rupture of the esophagus. Rev Gastroenterol. 1952 Jul;19(7):550-4.
- Mackler SA. Spontaneous rupture of the esophagus. An experimental and clinical study. Surgery, Gynecology & Obstetrics 1952; 95: 345-356.
- Shaffer AB, St Ville J, Mackler SA. Coronary arteriovenous fistula with patent ductus arteriosus. Am Heart J. 1963 Jun;65:758-65
- Rubenstein LH, Mackler SA. A review of implanted artifical cardiac pacemakers. Proc Inst Med Chic. 1970 Mar;28(2):82.
- Saul Allen Mackler’s Obituary, Chicago Tribune. 2007
- Marston EL, Valk HL. Spontaneous perforation of the esophagus: review of the literature and report of a case, Ann Intern Med. 1959
- Bouma HR, Scheer MLJ. Mackler’s triad: Boerhaave syndrome, Netherlands Journal of Critical Care. 2015
- Loftus IA, Umana EE, Scholtz IP, McElwee D. Mackler’s Triad: An Evolving Case of Boerhaave Syndrome in the Emergency Department. Cureus. 2023 Apr 22;15(4):e37978.
- Gunawardene A. Mackler’s triad in spontaneous pneumomediastinum. ANZ J Surg. 2023 Jan;93(1-2):437.
- Neto A, Knipe H. Mackler’s triad. Radiopaedia
the person behind the name
BA MA (Oxon) MBChB (Edin) FACEM FFSEM. Associate Professor Curtin Medical School, Curtin University. Emergency physician, Sir Charles Gairdner Hospital. Passion for rugby; medical history; medical education; and asynchronous learning #FOAMed evangelist. Co-founder and CTO of Life in the Fast lane | Eponyms | Books | Twitter |