Abstract

Although rare, spontaneous esophageal perforation or "Boerhaave syndrome", carries a high case fatality rate. The 'classic' presentation of chest pain, vomiting and subcutaneous emphysema is actually uncommon clinically, with the literature reporting variable initial presentations. Early recognition is critical for intervention, given its high mortality. Here we review reported presentations of Boerhaave syndrome, and discuss a rare case of Boerhaave syndrome presenting with right sided tension pneumothorax at our tertiary care center. A 56-year-old male was discovered unresponsive and brought by family to the local community emergency department. He was in respiratory distress, hemodynamically unstable, and tension pneumothorax was diagnosed with Boerhaave syndrome. He was immediately transferred to our tertiary care center, and underwent thoracotomy and primary repair of esophageal rupture. He was discharged home in stable condition after a 1-month recovery in the intensive care unit and thoracic surgical ward.

Authors and Affiliations