Fact-sheet: Boerhaave syndrome


Updated on 08/26/2020 at 2:34 PM

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Definition

Spontaneous esophageal rupture after vomiting efforts.

It is often located in the lower third of the esophagus.

Clinical features

Triad:

  • vomiting
  • chest pain
  • subcutaneous emphysema (crepitus)

Laboratory findings

unremarkable

Radiography

  • Pneumomediastinum

CT

First, non-contrast helical acquisition:

  • Discontinuity of the esophageal wall with esophagopleural or esophagomediastinal fistula.
  • Pneumomediastinum
  • Pleural effusion

Then, secondarily: Oral contrast study

Management

Surgical emergency: Suture of the esophageal defect.

Differential diagnosis

  • Esophageal perforation: different context (post-surgical or traumatic).