Boerhaave's Syndrome

The esophagus is the tubelike structure that carries food from the mouth to the stomach.  Boerhaave's syndrome occurs when the esophagus ruptures from forceful vomiting and/or retching, resulting in a tear or hole in the esophagus.

Nausea and vomiting Upper back pain at chest level that worsens with swallowing or breathing Sensation of difficulty taking in a deep breath

Stethoscope exam over the mediastinum may reveal crackles. Lung exam may show absent breath sounds due to a Pneumothorax (collapsed lung). Subcutaneous Emphysema may be palpable (felt) in the neck. Chest X-Ray may show subcutaneous Emphysema in the neck (often overlooked), air in the mediastinum, and/or a Pneumothorax. Gastrograffin (swallow) X-Rays confirm the diagnosis and the location.

Surgical repair of the esophageal rupture Broad spectrum intravenous antibiotics to treat or prevent mediastinitis

Mediastinitis -- this is an infection in the area of the chest that contains esophagus, heart, and major blood vessels.  Infections in this area can be catastrophic.

Mallory-Weiss Syndrome Intramural hematoma Esophagitis Esophageal ulcer Esophageal Cancer

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