Barogenic Rupture of the Esophagus (Boerhaave’s Syndrome)
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.
KeywordsEsophageal Perforation Tension Pneumothorax Mediastinal Pleura Esophageal Rupture Esophageal Defect
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- 1.Boerhaave H (1924) Atrocis nec descripti prius morph historia, secundum mediciae artis leges conseripta. Lugd Bal-Boukestaniana deyeden. English translation (1955) Bull Med Libr Assoc 43: 217Google Scholar
- 4.Payne WS, Brown PW, Fontana RS (1974) The esophagus. Lea and Febiger, PhiladelphiaGoogle Scholar
- 5.Madder SA (1952) Spontaneous rupture of the esophagus. An experimental and clinical study. Surg Gynecol Obstet 95: 345Google Scholar
- 11.Rao KVS, Mir M, Cogbill CL (1974) Management of perforation of the thoracic esophagus. A new technique utilizing a pedicle flap of the diaphragm. Am J Surg 127: 609Google Scholar
- 12.Urschel HC, Razzuk MA, Wood RE, Galbraith N, Pockey M, Paulson DL (1974) Improved management of esophageal perforation. Exclusion and diversion in continuity. Ann Surg 179: 587Google Scholar