Boerhaave Syndrome: A Report of Two Cases and Literature Review

Fawwaz, Baha Aldeen Bani; Gerges, Peter; Singh, Gurdeep; Rahman, Syed Hamaad; Al-dwairy, Ahmad; Mian, Arooj; Khan, Nihal; Farooq, Aimen

doi:10.7759/cureus.25241

Cited by 3 publications

(3 citation statements)

References 13 publications

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“…This occurs, for example, when there is violent vomiting and/or retching. More than 70% of perforations are thoracic, involving the posterolateral section of the distal esophagus, as in our case, but they can also occur in other parts of the esophagus, such as the intra-abdominal or cervical esophagus [ 5 , 6 ].…”

Section: Discussionmentioning

confidence: 90%

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Boerhaave’s Syndrome: An Unusual Geriatric Presentation

Canelas Mendes,

Duarte,

Madeira Lopes

2023

Cureus

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Boerhaave's syndrome (BS) is a non-iatrogenic spontaneous esophageal perforation that, if not appropriately recognized and managed, can cause localized infections such as mediastinitis, pneumonia, and empyema, as well as systemic infections with significant morbidity and mortality rates. An autonomous 83-year-old male presented to the emergency department with a three-day history of behavioral changes. Three days earlier, the patient had a self-limited episode of cough, nonspecific thoracalgia, palpitations, prostration, and pallor. On physical examination, he was alert but had temporal disorientation, hypoxemia, and pulmonary auscultation with abolished breath sounds in the middle third of the left chest. Laboratory tests showed hypoxemia, elevated C-reactive protein (28.2 mg/dL), and D-dimer (3.28 µg/mL). A chest X-ray revealed periaortic small bubbles, left atelectasis, and left pleural effusion. Computed tomographic angiography of the chest showed infra-carinal esophageal rupture, small bubbles of the anterior pneumomediastinum, and a loculated left pleural empyema. Mediastinitis and empyema due to BS were assumed. He underwent left thoracic drainage, broad-spectrum antibiotics, and the placement of a surgical esophageal prosthesis. He was discharged after 48 days. The condition known as BS is frequently misdiagnosed, mostly as a result of the lack of a preexisting pathological background and the wide array of potential symptoms that may manifest. The diagnosis in this particular case was rendered particularly complex due to the combination of an unusual presentation and a delayed seeking of medical attention. Against all expectations, our patient was successfully treated.

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Section: Discussionmentioning

confidence: 90%

“…Atypical presentations can make the diagnosis even more challenging, increasing morbidity and mortality [ 7 , 8 ]. Although the exact morbidity of this syndrome is unknown, it is considered high [ 5 ]. The importance of early clinical suspicion cannot be overstated.…”

Section: Discussionmentioning

confidence: 99%

Boerhaave’s Syndrome: An Unusual Geriatric Presentation

Canelas Mendes,

Duarte,

Madeira Lopes

2023

Cureus

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“…Management of Boerhaave's syndrome typically involves surgical intervention, with primary repair of the esophageal rupture being the mainstay of treatment. However, with advancements in the field of endoscopy, multiple endoscopic approaches have been successfully used in the management of Boerhaave's syndrome [11].…”

Section: Discussionmentioning

confidence: 99%

Mediastinitis and septic shock complicating spontaneous esophageal rupture “Boerhaave’s syndrome”: a case report

Kortli,

Andrianjafy

2024

Int J Emerg Med

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Boerhaave’s syndrome, also known as spontaneous esophageal rupture, is a rare but life-threatening condition characterized by a tear in the esophagus. It is most commonly caused by a sudden increase in intraesophageal pressure, often due to severe vomiting or retching.Early diagnosis of Boerhaave’s syndrome is crucial for improving patient outcomes. The classic triad of symptoms includes severe chest pain, vomiting, and subcutaneous emphysema (air under the skin). However, not all patients present with this triad, and the diagnosis can be challenging, especially in patients without the typical symptoms.In this case report, we present the clinical details of a 52-year-old male patient who presented to the emergency department (ED) with severe abdominal pain and vomiting for several days. The patient had a history of chronic alcohol abuse and a recent episode of vigorous vomiting.

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