[Boerhaave's syndrome. Emergency surgery]

The Authors report a case of spontaneous rupture of the esophagus in a 66-year-old alcoholic. The symptomatology was characterized essentially by epigastralgie and vomiting culminating in violent retrosternal pain radiating to the back and by shock. X-rays taken an hour after hospitalization showed an increase of pulmonary hypodiaphania with presence of pleural effusion at the left base, cervicothoracic subcutaneous emphysema. Emergency surgery was performed by thoracotomy associated with suture of the esophageal opening with drainage of the supradiaphragmatic and pleural region. However, the patient died on the 10th day of broncopulmonary complications. The Authors therefore believe that the triad pain, shock and mediastinal thoracico-cervical emphysema should be considered pathognomonical of Boerhaave's syndrome and thus be kept in mind by the surgeon employed in a Division of Emergency Surgery and First Aid.