boerhaave syndrome

Boerhaave syndrome (bs) is an uncommon and life-threatening disorder and is defined as spontaneous transmural esophageal perforation, which typically occurs after a projectile vomiting. the prognosis is dependent on early detection of the disease and appropriate management within 12 h of perforation. the typical presentations of bs are vomiting, subcutaneous emphysema, and pain in the lower chest. however, severe symptoms rarely happen, and about one-third of all patients present with atypical clinical features. therefore, bs should be suspected in any patient presenting with sudden thoracoabdominal pain with a history of vomiting. chest x-ray is the most helpful diagnostic tool, and computed tomography scan is applied for further evaluations. although surgical treatment is an important option for many patients, a less invasive procedure with or without endoscopic stent or internal or external drains, with respect to patient’s clinical condition, is preferable.