Podcast #231: Esophageal Tearing

Author: Jared Scott, M.D.

Educational Pearls

• Boerhaave syndrome (aka effort rupture of the esophagus) accounts for 10% of esophageal ruptures and is usually caused by strain during vomiting episodes. It can also be caused by childbirth, seizure, or prolonged coughing or laughing.
• Food and water swallowed after the tear end up in the mediastinum, eventually causing infection. Therefore, Boerhaave syndrome is a surgical emergency.
• Best diagnostic techniques are CT or endoscopy.
• Mallory-Weiss syndrome may present similarly, however it is less serious since it involves only a small tear through the mucosa at the gastroesophageal junction. This can be managed on an outpatient basis with PPI's.

References: https://radiopaedia.org/articles/boerhaave-syndrome