Boerhaave syndrome

Case contributed by RMH Core Conditions
Diagnosis almost certain

Presentation

Emaciated, loss of weight, right apex opacity on chest x-ray? TB? occult malignancy?

Patient Data

Age: 80 years
Gender: Female

Chest

ct

Extensive pneumomediastinum and fluid in the mediastinum. Proximal esophagus is air-filled and distended to the level of T7 and after this it is largely collapsed. Moderate sized bilateral pleural effusions and a small right apical pneumothorax. Severe centrilobular emphysema. 

Case Discussion

Boerhaave syndrome is spontaneous esophageal rupture from forceful vomiting. After initial concerns for the pneumomediastinum secondary to perforation esophageal malignancy, this case was given the clinical diagnosis of Boerhaave syndrome. 

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