Boerhaave's syndrome--an unusual cause of acute retrosternal pain]

Boerhaave's syndrome or spontaneous perforation of the oesophagus is a rare condition with a severe prognosis. Adequate treatment is often delayed because of misdiagnosis of the condition as cardial, pulmonary or other gastrointestinal disease, with a concomitant rise in mortality.A case of Boerhaave's syndrome is described. An 88-year-old male presented with acute retrosternal pain, initially believed to be caused by cardiac disease. After a delay of more than 24 hours, laparotomy revealed a perforation of the oesophagus.The patient was treated with laparotomy, drainage, antibiotics, antifungal and medical supportive therapy. Surgical closure of the lesion was not performed because of the debilitated state of the patient and the delay in diagnosis. He left the hospital in his habitual state after 33 days of hospitalization.Boerhaave's syndrome is a serious condition that is often misdiagnosed. The preferred treatment is prompt surgical closure of the oesophageal defect.