Presentation
Emaciated, loss of weight, right apex opacity on chest x-ray? TB? occult malignancy?
Patient Data
Age: 80 years
Gender: Female
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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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