Lynchburg Journal of Medical Science

Lynchburg Journal of Medical Science


Emergency Medicine


Tom Colletti


Boerhaave’s syndrome, or spontaneous esophageal rupture, is a rare condition caused by an abrupt rise in intraluminal esophageal pressure, most commonly seen after vomiting. Meckler’s triad is commonly associated with Boerhaave’s and includes vomiting, lower chest pain, and subcutaneous emphysema. Early recognition of Boerhaave’s is critical but can be difficult given the wide variety of clinical presentations that can mimic other cardiopulmonary pathologies. An esophageal rupture is best visualized with diagnostic imaging. There currently is no standardized treatment algorithm, but conservative therapy is recommended in all patients. Endoscopic or open surgical repair provides a more definitive management in patients with Boerhaave’s.


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