Spontaneous esophageal rupture (Boerhaave syndrome) with complications in a patient with advanced reflux esophagitis with no evidence of contrast agent leakage

Introduction: Boerhaave syndrome involves spontaneous rupture of the esophagus after forceful vomiting in alcoholics. Case report: A 42-year-old male alcoholic was admitted to our ward on 11.26.07. After heavy alcohol intake, the patient vomited coffee-ground like matter and experienced bilaterally thoracic pain. The chest- and abdominal X-ray were negative. During gastroscopy, at the esophageal entrance we observed a fibrinous layer, which at 25cm assumed a circular shape partly detached from the esophagus wall. It continued to the level of the cardia with a hiatic hernia visible at 41–44cm. The next day, above…