BOERHAAVE SYNDROME: A Case Report

Introduction: Boerhaave syndrome is a spontaneous longitudinal transmural rupture of the esophagus, first described in 1724 by German physician Herman Boerhaave. Spontaneous ruptures constitute 15% of all esophageal ruptures, typically occurring after persistent vomiting that leads to a sudden increase in intraluminal esophageal pressure. The syndrome has a high mortality rate and presents with Mackler's triad: vomiting, mild chest pain, and subcutaneous emphysema. Case Report: This case report describes a 63-year-old male who presented to the emergency department with severe chest and upper abdominal pain. Physical examination revealed tenderness in the upper quadrants and mild crepitus around the neck. A thoracoabdominal CT scan showed extraluminal air in the mid-lower esophageal area, leading to a diagnosis of Boerhaave syndrome. Emergency surgery included a right-sided thoracotomy, revealing a 3 cm esophageal perforation, which was repaired. Postoperatively, the patient was treated in the intensive care unit with expanded antibiotic therapy and managed for various complications. The patient was discharged on the 18th postoperative day. Conclusion: Early diagnosis and treatment of Boerhaave syndrome are critical for improving patient survival. Detailed patient history, recognition of clinical symptoms, and the use of appropriate diagnostic tools are essential for accurate diagnosis and timely surgical intervention.