Spontaneous transmural rupture of the lower oesophagus, usually as a result of forceful vomiting. Rupture of the oesophagus allows gastric content to enter the mediastinum and pleural spaces, which may lead to surgical emphysema, empyema and over-whelming sepsis. Mackler's triad describes the vomiting, lower thoracic pain and subcutaneous emphysema but the triad can happen without oesophageal perforation
Mortality is high. Surgical repair in most cases. Endoscopic treatment using covered, self-expanding stents has been employed successfully in several cases although late aorto-oesophageal fistula has been described.
- ↑ Forshaw MJ, Khan AZ, Strauss DC, Botha AJ, Mason RC. Vomiting-induced pneumomediastinum and subcutaneous emphysema does not always indicate Boerhaave's syndrome: report of six cases. Surgery today. 2007; 37(10):888-92.(Link to article – subscription may be required.)
- ↑ Eubanks PJ, Hu E, Nguyen D, Procaccino F, Eysselein VE, Klein SR. Case of Boerhaave's syndrome successfully treated with a self-expandable metallic stent. Gastrointestinal endoscopy. 1999 Jun; 49(6):780-3.
- ↑ Davies AP, Vaughan R. Expanding mesh stent in the emergency treatment of Boerhaave's syndrome. The Annals of thoracic surgery. 1999 May; 67(5):1482-3.
- ↑ Hill AG, Tiu AT, Martin IG. Boerhaave's syndrome: 10 years experience and review of the literature. ANZ journal of surgery. 2003 Dec; 73(12):1008-10.