Boerhaave syndrome

Key points• Boerhaave syndrome is a surgical emergency, defined as a spontaneous perforation of the oesophagus, typically located in the distal left posterolateral aspect • The most common clinical presentation is vomitting followed by chest pain combined with signs of infection • The initial diagnostic work-up consists of contrast-enhanced CT of the chest and upper abdomen • The mainstay of treatment is endoscopic or surgical closure of the oesophageal defect and drainage of perioesophageal fluid collections • The choice of initial endoscopic or surgical treatment is largely dependent on the treating centre's individual experience and preference, with no guidelines currently available