Boerhaave's Syndrome: Presenting with Chest Pain

Abstract

Boerhaave Syndrome or spontaneous oesophageal rupture is a rare, potentially fatal condition (1-3). Patients usually present with pain, dyspnoea and signs of shock after forced vomiting (4). The Meckler triad consisting of vomiting, pain and subcutaneous emphysema is characteristic for Boerhaave Syndrome, although it is observed in only 30−50% of affected patients (5, 6). We present a case report of Boerhaave's syndrome presenting with chest pain after vomiting. A 47-year-old woman presented to our Emergency Department after sudden, left-sided chest pain after vomiting. On admission, her general status was moderately well. On physical examination, her breath sounds were diminished on the left haemithorax. A chest X-ray taken for diminished breath sounds on the left haemithorax showed pneumothorax and pleural effusion in the left haemithorax (Fig. 1). The patient was referred to the Thoracic Surgery Department and a tube thoracostomy was performed. It was immediately noted that gastric contents drained out of the tube (Fig. 3).