Boerhaave syndrome: spontaneous oesophageal rupture resulting from sudden increased intra-oesophageal pressure. Most commonly associated with emesis with incomplete cricopharyngeal relaxation.
Oesophageal contents may leak into the mediastinum and pleural space resulting in mediastinitis and a mortality of 40–90% if not recognised and treated promptly
Left posterolateral distal oesophagus is most commonly the site of rupture. Radiographic imaging (CXR, CT scan) commonly reveal pneumomediastinum, mediastinal fluid, and pleural effusion
1724 – Baron Jan von Wassenaer, the Grand Admiral of the Dutch Fleet and Prefect of Rhineland, ingested an emetic after eating a large meal. The forceful vomiting was associated with a tearing pain in the chest and the Baron died 24 hours later.
Boerhaave: Advice for future cases
- Herman Boerhaave (1668–1738)
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