Spontaneous Rupture of the Esophagus (Boerhaave Syndrome)

Publisher Website
Google Scholar
Abstract
SPONTANEOUS rupture of the esophagus, also called Boerhaave syndrome after the Dutch physician who first reported it in 1724,1was often undiagnosed or misdiagnosed in living patients, resulting in a fatal outcome. In Boerhaave syndrome, patients experience violent vomiting followed by severe chest pain, prostration, and, inevitably, death from the ruptured esophagus. This syndrome was formerly diagnosed only at autopsy.2-4 Since Barrett's5report of the first successful surgical treatment of the condition in 1947, other reports and reviews, mostly in the surgical literature, have emphasized the necessity of early diagnosis and rapid medical and surgical treatment to ensure patient survival.6-13 The major diagnostic problem is still that esophageal rupture is often not considered initially among possible diagnoses by the primary physician. Rather, the patient's symptoms are often misdiagnosed as being caused by acute myocardial infaction, ruptured peptic ulcer, pulmonary embolism, pancreatitis, or dissecting aortic aneurysm. Hence,