Abstract

Boerhaave’s syndrome is a rare condition but potentially fatal condition characterized by a transmural tear of the distal esophagus induced by a sudden increase in intra luminal pressure. Diagnosis is challenging and usually delayed as the classical triad of vomiting, abdominal or chest pain, and subcutaneous emphysema is absent in many patients. Treatment has not been standardized and may be conservative, endoscopic or surgical.

We present a typical case which illustrates possible diagnostic pitfalls and the therapeutic conundrum surrounding management of the syndrome. Based on time of presentation and eventual presence of sepsis, a therapeutic algorithm is proposed

Key words: Boerhaave's syndrome; Spontaneous perforation; Oesophagus.