[Atraumatic complete esophageal rupture (Boerhave's syndrome) (author's transl)]

Two of our own patients with Boerhave's syndrome are reported. A disturbance of the vomiting process with abrupt increase of pressure in the esophageal lumen combined with a circumscribed constitutional weakness of the esophageal wall appears to be the decisive factor in the etiology of atraumatic complete esophageal rupture. The clinical picture is characterized by vomiting and painful sensations in the abdomen and thorax in addition to subsequent acute epigastric symptomatology. A water-soluble contrast medium is very useful in the radiological diagnosis. Thoracotomy with suture and drainage is recommended as the treatment of choice. Operative treatment treatment has a mortality of 38% compared with more than 60% with drainage alone.