[Spontaneous esophageal perforation (Boerhaave syndrome)]

A review of the literature reveals that the prognosis is unfavorable in the presence of spontaneous rupture of the esophagus, since approximately 50 per cent of the patients die. It is also generally true that the mortality will increase in a direct relationship to the time elapsed between the onset of the clinical syndrome and the arrival at a correct diagnosis and adequate treatment. The author presents a case review of the so-called Boerhaave's Syndrome in which the correct diagnosis was made and surgical treatment instituted within eight hours of onset. He emphasizes the importance of a careful consideration of the clinical and radiologic findings and especially that of mediastinal and subcutaneous emphysema.