Spontaneous Perforation of the Oesophagus: Review of the Literature and Report of Three New Cases

Esophageal Perforation: Clinical Patterns and Outcomes from a Patient Cohort of Western Norway

“…The spontaneous perforation group comprised 6 patients with true Boerhaave syndrome [14], and 8 patients with spontaneous perforations related to various conditions, including malignant esophageal tumors (with or without a stent in place), infections or fistula, or suggested esophageal ischemia or inflammation. The cause of perforation was categorized as iatrogenic when the perforation occurred in relation to diagnostic (e.g.…”

“…Prospective randomized trials with appropriate statistical power are not available due to the rarity of this condition, so the core knowledge is provided from various retrospective institutional [5,6,7,8,9,10,11,12] or community-based series [3,4,13]. Patients with spontaneous perforation of a healthy esophagus (Boerhaave syndrome [14,15]) represent a subgroup of particular concern [16]. Heterogeneity with regard to study populations, diagnostic work-up, and applied treatments makes comparisons difficult.…”

Rupture of the œsophagus associated with lesions of the central nervous system

“…The oesophagus could only rupture after death as a result of gross autolysis, and it is impossible for this to take the form of a linear tear. Furthermore, the position and shape of the lesion is identical with that found in spontaneous rupture (Barrett, 1946 ;Grigsby, Brown, and Cave, 1953 ;Collis, Humphreys, and Bond, 1944 ;Ware and Strieder, 1949 ;and Walker, 1914).…”

Management of spontaneous rupture of the oesophagus (Boerhaave’s syndrome): Single centre experience of 18 cases

“…One patient died, a 6o-year-old man who had presented profoundly shocked and with acute tubular necrosis and haemodynamic failure, succumbing to ARDS and overwhelming multiple organ failure on the 19th postoperative day. The commonest age of presentation is between 4o and 6o years of age, with a slight male predominance with male to female ratio of 2 two of these however who had been discharged from hospital succumbed to massive upper gastrointestinal bleeding from an oesophagealaortic fistula. In one further patient the stent did not control the fistula, and due to this and progressive sepsis that patient underwent an oesophagectomy.…”

“…2 The mortality rate was approximately 50% up to the 19805, but more recently the mortality rate is approximately 30% because of earlier diagnosis, surgical repair and improvements in intensive care. [3][4][5][6][7] The typical pattern, so-called Mackler's Triad, of spontaneous oesophageal perforation is violent retching or vomiting following food and very often alcohol, which is then followed by severe chest pain and surgical emphysema.'…”