Boerhaave’s syndrome in a case of acute exacerbation of chronic obstructive pulmonary disease managed with non-invasive ventilation: a case report

Barotraumatic esophageal rupture (Boerhaave’s syndrome) is a rare and life-threatening disease, described as a Non-Invasive Ventilation (NIV) complication in a very small series. We report the case of a 72-year-old man admitted to the Emergency Department (ED) for severe dyspnea in a Chronic Obstructive Pulmonary Disease (COPD) stage Gold III. After NIV treatment, the patient suffered esophageal perforation with mediastinal and pleural contamination: emergency surgical treatment was successful for the esophageal repair, but the patient developed a fatal septic shock 12 days after surgery. Among NIV complications, few cases concern esophagogastric perforation: our case report describes an uncommon clinical situation treated with a successful damage control surgery approach.