[Boerhaave syndrome or spontaneous rupture of the esophagus]

Spontaneous rupture of esophagus is a rare affection resulting from barotrauma to lower esophagus during the effort of vomiting. The diagnosis is suggested by the presence of violent retrosternal pain after a bout of vomiting following the partaking of a copious meal by an alcoholic patient. Prognosis is dependent on the rapidity of treatment, always surgical and completed by long-term antibiotic therapy. Complementary examinations should be limited to a standard chest x ray and esophageal imaging with water-soluble contrast. Recovery is now the rule for patients treated within 24 hours. Mortality is high in patients diagnosed at a late stage, but this could be reduced by improved recognition of the syndrome.