Barogenic Rupture of the Esophagus (Boerhaave’s Syndrome)

Abstract

Barogenic rupture of the esophagus, first described in 1724 by Boerhaave (1), a Dutch physician, is the most lethal of all gastrointestinal perforations. Untreated, 25% of patients are dead within twelve hours; the remainder die in less than a week (2). The present-day mortality rate for the condition is approximately 35% (3); delay in treatment, essentially due to delay in diagnosis, is responsible for this disturbingly high mortality. The relative rarity of this condition, misinterpretation of its presenting features, and failure to recognize the early X-ray manifestations contribute to delayed diagnosis.