Boerhaave syndrome is the perforation of the esophagus caused by forceful vomiting due to increased intra-esophageal pressure combined with relatively negative intra-thoracic pressure.

This syndrome is associated with Mackler's triad (vomiting, chest pain, and subcutaneous emphysema). 

Chest x-ray and CT chest help to confirm the diagnosis of Boerhaave syndrome and should be considered immediately in suspected patients.

Special thanks to Professor Anuchit Ruamthanthong.