Boerhaave syndrome

Case contributed by Domenico Nicoletti
Diagnosis certain

Presentation

After supper, vomiting with intense epigastric pain.

Patient Data

Age: 55 years
Gender: Male

Chest

ct
This study is a stack
Axial C+ portal
venous phase
This study is a stack
Axial lung
window
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Info

Large tear in the thoracic oesophagus in the anterior left side, about 3-4 cm from the cardia with evidence of mediastinal collection, and pneumomediastinum.

ct
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Info

Zoomed image of area of oesophageal rupture with pneumomediastinum. 

Case Discussion

Surgical report: laceration above a narrowing of the oesophageal mucosa (? achalasia ? chronic oesophagitis). The oesophageal mucosa at the level of the tear is rosy and well vascularised.

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