Boerhaave Syndrome

Boerhaave syndrome (BS) is an uncommon and life-threatening disorder and is defined as spontaneous transmural esophageal perforation, which typically occurs after a projectile vomiting. The prognosis is dependent on early detection of the disease and appropriate management within 12 h of perforation. The typical presentations of BS are vomiting, subcutaneous emphysema, and pain in the lower chest. However, severe symptoms rarely happen, and about one-third of all patients present with atypical clinical features. Therefore, BS should be suspected in any patient presenting with sudden thoracoabdominal pain with a history of vomiting. Chest X-ray is the most helpful diagnostic tool, and computed tomography scan is applied for further evaluations. Although surgical treatment is an important option for many patients, a less invasive procedure with or without endoscopic stent or internal or external drains, with respect to patient’s clinical condition, is preferable.