Images in Clinical Medicine

Boerhaave's Syndrome

Ramana Gopalan, M.D., M.P.H., and Colleen G. Cooke, M.D.

N Engl J Med 2000; 343:190July 20, 2000

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Figure 1 A 71-year-old man began to have burning substernal pain while he was eating a sandwich. The pain became excruciating, worsened with breathing, and was accompanied by dyspnea. On admission to the hospital, he had hypoxemia, an elevated blood pressure, coarse rales in both lung bases, epigastric and flank tenderness, and diminished bowel sounds. A nasogastric tube was inserted, and a small amount of bloody fluid was removed. Computed tomography of the chest through the superior mediastinum with the use of intravenous and oral contrast medium showed air (A) in the mediastinum adjacent to the esophagus (E) and the trachea (T), indicating the occurrence of spontaneous esophageal rupture (Boerhaave's syndrome). The patient underwent bilateral thoracotomy, with placement of chest tubes. He recovered after a 27-day hospital stay.

Ramana Gopalan, M.D., M.P.H.
Colleen G. Cooke, M.D.
Greater Baltimore Medical Center, Baltimore, MD 21204

Citing Articles (2)

Citing Articles

1. 1

   Richard A. Harrigan, Michael A. DeAngelis. 2007. Evaluation and Management of Patients with Chest Syndromes. , 1-16.
   CrossRef

2. 2

   (2001) Boerhaave's Syndrome. New England Journal of Medicine 344:2, 138-139
   Full Text