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11 September 2026

Diagnostic Approach and Therapeutic Management of Spontaneous Esophageal Perforation (Boerhaave’s Syndrome): A Systematic Review and Individual Patient-Level Pooled Analysis

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1
First Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, 11527 Athens, Greece
2
Department of Colorectal Surgery, Royal Marsden Hospital, NHS Foundation Trust, London SW3 6JJ, UK
3
Second Propaedeutic Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, 11527 Athens, Greece
4
General and Upper GI Surgical Unit, Royal Infirmary of Edinburgh, Edinburgh EH16 4SA, UK
J. Clin. Med.2026, 15(18), 7032;https://doi.org/10.3390/jcm15187032
This article belongs to the Special Issue Advances and Clinical Updates in the Gastrointestinal and Abdominal Diseases
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Abstract

Background/Objectives: Boerhaave’s syndrome (BS) is a rare, life-threatening condition associated with high mortality. This systematic review aimed to summarize the clinical presentation, management, and outcomes of adult patients with BS. Methods: PubMed and Scopus were searched through 12 June 2026 for case reports and case series reporting individual patient-level data. Demographic, clinical, diagnostic, therapeutic, and outcome data were extracted. Risk of bias was assessed using the Joanna Briggs Institute Critical Appraisal Checklist, and factors associated with in-hospital mortality were explored using logistic regression. Results: A total of 427 studies comprising 694 patients were included. Mean age was 57.1 years and 523 patients (80.6%) were male. Vomiting (79.5%) and chest pain (60.7%) were the most common symptoms, while 263 patients (67.6%) met SIRS criteria at diagnosis. The distal esophagus was involved in 83.5% of cases, and computed tomography was the predominant diagnostic modality (55.5%). Surgery was the most common first-line treatment (62.8%). In-hospital and 30-day mortality were 18.2% and 15.4%, respectively. In exploratory analyses, increasing age and SIRS were associated with in-hospital mortality. Risk of bias assessment identified methodological concerns across studies predominantly due to selective and incomplete outcome reporting. Certainty of evidence for in-hospital mortality was very low according to GRADE. Conclusions: BS remains associated with substantial morbidity and mortality. Surgery remains the most frequently applied treatment, while conservative and endoscopic strategies are used in selected patients. Case-based evidence precludes reliable comparative assessment of treatment effectiveness. The association between SIRS and mortality remains hypothesis-generating.

1. Introduction

Boerhaave’s syndrome (BS) is a rare but life-threatening clinical entity, characterized by spontaneous esophageal perforation resulting from sudden distal esophageal pressurization, most frequently precipitated by forceful vomiting, in the context of negative intrathoracic pressure [1,2]. Although it was first described in 1724 by Hermann Boerhaave, successful surgical management was not reported until more than two centuries later by Barrett et al. [3,4]. BS accounts for approximately 15% of all esophageal perforations, with an age-standardized incidence of 0.31 cases per 100.000 population annually [5]. Despite substantial improvements in diagnostic and therapeutic management, mortality rates remain considerable, ranging from 15% to 50%, due to mediastinal contamination and sepsis development [1,5].
The principles of treatment include hemodynamic support, definitive closure of the esophageal defect and adequate drainage of pleural collections. Although surgical repair has traditionally been the mainstay of treatment, the therapeutic spectrum has expanded considerably with advances in interventional endoscopy [1,6]. Endoscopic approaches, comprising self-expandable metal stent placement and endoscopic vacuum therapy (EVT), provide less invasive, organ-preserving options in appropriately selected patients [6,7,8]. A recent multinational retrospective cohort study found no significant differences in in-hospital and 90-day mortality between endoscopic and surgical approaches, although treatment selection depends strongly on clinical presentation [9].
Nevertheless, the existing evidence for BS largely derives from retrospective single-center series, while larger cohorts frequently combine spontaneous perforation with other etiologies of esophageal injury. Consequently, uncertainty persists regarding the optimal management of BS and guideline recommendations rely on low-certainty evidence [10]. This heterogeneity limits the comparability of reported outcomes and complicates clinical decision-making. This systematic review and individual patient-level pooled analysis aims to synthesize current evidence on the clinical presentation, diagnostic and therapeutic strategies, as well as outcomes of BS in adults, to identify multidisciplinary approach patterns and delineate gaps in contemporary management.

2. Materials and Methods

2.1. Review Registration

This systematic review was prospectively registered in the Open Science Framework (http://www.osf.io/) with the unique identifying number: 10.17605/OSF.IO/GAM2S. It was conducted and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 statement [11]. The PRISMA 2020 Checklist is provided in the Supplementary Materials.

2.2. Search Strategy and Information Sources

A systematic search of the literature was independently performed by two reviewers (E.M., M.F.) using the PubMed and Scopus databases. The search included all records from database inception through 12 June 2026 and used the terms “Boerhaave syndrome” OR “esophageal perforation” to identify studies on the diagnostic and therapeutic management of adult patients with BS. To enhance the sensitivity of the search strategy, the reference lists of all eligible articles were manually examined to identify additional eligible articles.
Following the removal of duplicate studies, titles and abstracts were independently screened by two reviewers (E.M., M.F.). Once non-relevant studies were excluded based on the abstract screening, a full-text review of the remaining studies was performed to confirm their eligibility. Any disagreements that arose between the two reviewers were resolved by a third senior reviewer (D.S.).

2.3. Eligibility Criteria and Data Extraction

Studies were considered eligible for inclusion if they satisfied the predefined Patient, Exposure, Comparator, Outcome, and Type of Study (PECOT) framework:
P (patients): Adult patients undergoing treatment for BS. Only cases of spontaneous transmural esophageal perforation, without an iatrogenic, traumatic, or other secondary etiology, were considered eligible for inclusion.
E (exposure): Any therapeutic intervention for BS.
C (comparator): Not applicable.
O (outcome): Clinical characteristics, diagnostic modalities, treatment strategies, and clinical outcomes.
T (type of study): Case reports and case series.
Studies were excluded if they were published in a non-English language, did not report data at an individual patient level, included a paediatric population (defined as age < 18 years), or were narrative or prior systematic reviews.
Data were extracted independently from all eligible studies by two reviewers (E.M., M.F.). The following variables were systematically collected: study authorship, year of publication, country of origin, and study design. Patient-level demographic and clinical characteristics, including age, sex, and presenting symptoms, were recorded.
Detailed disease- and treatment-related variables were also extracted, including the anatomical location, laterality, and size of the esophageal perforation, the time interval from symptom onset to diagnosis, the time between hospital admission and initiation of treatment, diagnostic methods utilized, and the type of therapeutic intervention administered. First-line treatment was defined as the initial therapeutic approach implemented following diagnosis, whereas second-line treatment referred to any subsequent intervention required due to failure or complications of the initial management. Additional outcomes of interest included admission to the intensive care unit (ICU), duration of ICU and total hospital stay, postoperative or treatment-related complications, and hospital readmissions. Mortality outcomes (in-hospital and 30-day mortality) and duration of follow-up were also documented.

2.4. Methodological Quality, Risk of Bias, and Certainty of Evidence Assessment

Methodological quality and risk of bias of the included studies were independently evaluated by two reviewers (E.M., M.F.) using the Joanna Briggs Institute Critical Appraisal Checklist for Case Reports [12]. Discrepancies arising were resolved by consultation with a third reviewer (D.S.). The certainty of the evidence for the primary outcome, in-hospital mortality, was assessed in accordance with the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework [13]. The overall quality of evidence was classified as high, moderate, low, or very low after consideration of the following domains: risk of bias, inconsistency of results, indirectness of evidence, imprecision of effect estimates, and potential publication bias.

2.5. Statistical Analysis

Continuous variables were reported as mean and standard deviation (SD) or median and interquartile range (IQR). Categorical variables were presented as absolute counts and relative frequencies. Because reporting was incomplete and heterogeneous across the included case reports and case series, analyses were performed using available case data. No imputation of missing values was performed. For each variable, patients with missing or unreported data were excluded only from the analysis of that specific variable. Therefore, denominators vary across variables and are explicitly reported throughout the Results. Potential duplicate reporting was assessed by cross-checking authorship and available patient-level demographic and perforation characteristics across publications; no duplicate patients were identified.
Univariate logistic regression models were constructed with in-hospital mortality, ICU admission, need for second-line treatment, and postoperative complications as dependent variables. For in-hospital mortality, a multivariate logistic regression model was developed in accordance with the rule of thumb, including variables with p < 0.2 in the univariate analysis. Backward stepwise selection was applied to obtain the final model. Odds ratios (ORs) with 95% confidence intervals (CIs) are reported. All regression analyses were conducted using complete observations for the variables included in the respective model, without imputation of missing covariate or outcome data. Given the case-based nature of the dataset, heterogeneity in reporting and missingness for several variables, all regression analyses were considered exploratory and hypothesis-generating rather than confirmatory or causal.
In addition, given the extended publication period of the included literature and the substantial evolution in diagnostic modalities, endoscopic techniques, surgical management and perioperative care over time, a prespecified subgroup analysis restricted to studies published from 2000 onwards was performed. This analysis was intended to assess whether the principal descriptive findings and outcome patterns observed in the overall cohort remained applicable to more contemporary clinical practice. A p-value < 0.05 was considered statistically significant. Statistical analysis was performed using R statistical software (version 4.2.2).

3. Results

3.1. Study Characteristics and Patient Demographics

A total of 427 studies [14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53,54,55,56,57,58,59,60,61,62,63,64,65,66,67,68,69,70,71,72,73,74,75,76,77,78,79,80,81,82,83,84,85,86,87,88,89,90,91,92,93,94,95,96,97,98,99,100,101,102,103,104,105,106,107,108,109,110,111,112,113,114,115,116,117,118,119,120,121,122,123,124,125,126,127,128,129,130,131,132,133,134,135,136,137,138,139,140,141,142,143,144,145,146,147,148,149,150,151,152,153,154,155,156,157,158,159,160,161,162,163,164,165,166,167,168,169,170,171,172,173,174,175,176,177,178,179,180,181,182,183,184,185,186,187,188,189,190,191,192,193,194,195,196,197,198,199,200,201,202,203,204,205,206,207,208,209,210,211,212,213,214,215,216,217,218,219,220,221,222,223,224,225,226,227,228,229,230,231,232,233,234,235,236,237,238,239,240,241,242,243,244,245,246,247,248,249,250,251,252,253,254,255,256,257,258,259,260,261,262,263,264,265,266,267,268,269,270,271,272,273,274,275,276,277,278,279,280,281,282,283,284,285,286,287,288,289,290,291,292,293,294,295,296,297,298,299,300,301,302,303,304,305,306,307,308,309,310,311,312,313,314,315,316,317,318,319,320,321,322,323,324,325,326,327,328,329,330,331,332,333,334,335,336,337,338,339,340,341,342,343,344,345,346,347,348,349,350,351,352,353,354,355,356,357,358,359,360,361,362,363,364,365,366,367,368,369,370,371,372,373,374,375,376,377,378,379,380,381,382,383,384,385,386,387,388,389,390,391,392,393,394,395,396,397,398,399,400,401,402,403,404,405,406,407,408,409,410,411,412,413,414,415,416,417,418,419,420,421,422,423,424,425,426,427,428,429,430,431,432,433,434,435,436,437] published between 1961 and 2026 were included (Figure 1), comprising 694 patients diagnosed with BS. The mean age of patients was 57.1 years (SD 16.3). Gender was reported for 649 patients, and the majority were male (80.6%). Precipitating factors were documented in 199 patients. Acute alcohol consumption was identified as the most common trigger (51.8%), either alone or in combination with meal ingestion. Preexisting esophageal pathology was reported in 76 patients, with gastroesophageal reflux disease (40.8%) and Barrett’s esophagus (17.1%) being the most prevalent conditions.
Figure 1. The PRISMA 2020 flowchart of included studies.

3.2. Anatomical Characteristics of Esophageal Perforation

Data on perforation location were available for 473 patients. The distal esophagus was the most frequently impacted segment, accounting for 83.5% of cases, followed by the middle esophagus (11.4%) and upper esophagus (4.0%). Laterality was reported for 235 patients, and perforations most commonly occurred on the left side (77%). Circumferential orientation was available for 74 patients, with posterolateral being the most common (34.7%), followed by posterior (29.2%) and lateral alone (22.2%), while anterior accounted for 8.33% of patients. The median size of the defect was 3 cm (IQR 2 cm). Table 1 summarizes patient and anatomical characteristics.
Table 1. Demographic and clinical characteristics.

3.3. Clinical Presentation

Data on clinical presentation were available for 570 patients. Vomiting was the most frequently reported presenting symptom (79.5%), followed by chest pain (60.7%), and abdominal pain (35.8%). Respiratory symptoms, including dyspnea (29.0%) and cough (5.6%), were also commonly documented. Systemic manifestations were prevalent, with 67.6% of patients fulfilling the criteria for systemic inflammatory response syndrome (SIRS) at the time of initial diagnosis. The interval between symptom onset and diagnosis was reported for 337 patients. While approximately 45.5% were diagnosed within 24 h, 34.7% of patients experienced diagnostic delays exceeding 72 h.

3.4. Diagnostic Evaluation

Diagnostic modalities were reported in 528 patients. Computed tomography (CT) was the most frequent imaging modality (55.5%), followed by endoscopy (22.7%) and water-soluble contrast studies (16.9%). Chest radiography was utilized in 12.5% of cases, primarily as an initial screening tool. In a minority of patients, the diagnosis was established intraoperatively.

3.5. Therapeutic Strategies

First-line treatment data were available for 670 patients. Surgical management constituted the predominant therapeutic approach (62.8%), followed by conservative (18.2%) and endoscopic (16.3%) strategies. Among patients undergoing endoscopic therapy, stent placement was the most employed modality (71.5%), followed by clip placement (17.9%) and EVT (8.94%). Surgical interventions varied considerably, with primary repair, either without (60.8%) or with reinforcement (26.1%), being the most frequently performed procedure. Esophagectomy was performed in 17.1%, with reconstruction performed in 8.4% of patients. Lavage and drainage were performed in 58.8%, decortication in 18%, and feeding jejunostomy in 25.8% of patients.
Second-line treatment was required in 40.1% of patients, most frequently including surgical intervention (24.0%) or endoscopic therapy (12.1%). Chest tube placement was performed in 430 patients (87.6%). Among patients with available data (n = 201), treatment was initiated within 24 h of hospital admission in 63.2% of cases. Table 2 consolidates the treatment strategy.
Table 2. Treatment.

3.6. Clinical Outcomes

In-hospital mortality was reported in 649 patients and occurred in 18.2% of cases, while 30-day mortality was documented in 644 patients and was 15.4%. ICU admission was reported in 302 patients, of whom 76.5% required critical care. The median length of ICU stay was 10 days (IQR 16), while the median hospital stay was 25 days (IQR 33).
Post–first-line treatment complications occurred in 300 patients (63.8%), with leakage (17.2%), empyema (11.3%), and sepsis (8.9%) being the most frequently reported adverse events. Stent-related complications included migration in 18.1% of cases, while healing after stent placement was achieved in 75 (79%) out of 95 patients with available follow-up data. Readmissions were documented in 53.7% of reported cases. The median follow-up duration was 6 months (IQR 9). Table 3 summarizes clinical outcomes.
Table 3. Clinical outcomes.

3.7. Factors Associated with In-Hospital Mortality

On univariate analysis, increasing age, female sex, delayed diagnosis (>24 h), and the presence of SIRS at initial presentation were significantly associated with increased in-hospital mortality. Increasing age was associated with a higher risk of death, with 5% higher odds of in-hospital death per additional year of age (OR 1.05, 95% CI 1.04–1.07; p < 0.001). Female sex was also associated with 1.72-fold higher odds of in-hospital mortality (OR 1.72, 95% CI 1.05–2.77; p = 0.029). A diagnostic delay exceeding 24 h was associated with more than a twofold increase in in-hospital mortality risk (OR 2.24, 95% CI 1.23–4.23; p = 0.010). Patients presenting with SIRS at initial diagnosis had 5.67 times higher odds of in-hospital mortality (OR 5.67, 95% CI 2.79–13.16; p < 0.001).
The multivariable analysis included 199 patients with complete data for age, diagnostic delay, SIRS at diagnosis, and in-hospital mortality, among whom 35 (17.6%) died during hospitalization. In multivariate analysis, age and SIRS at initial diagnosis remained associated with in-hospital mortality. Patients exhibited 5% higher odds of in-hospital mortality for each additional year of age, adjusted for delay to diagnosis and SIRS at initial diagnosis (OR 1.05, 95% CI 1.02–1.08; p < 0.001). Similarly, the presence of SIRS was associated with a 9.23-fold increase in the odds of in-hospital mortality adjusted for age and diagnostic delay (OR 9.23, 95% CI 2.58–59.36; p = 0.004). In contrast, diagnostic delay did not retain statistical significance after adjustment for confounding factors (Table 4).
Table 4. Univariate and multivariate analysis for in-hospital mortality.

3.8. Associations Between Treatment Strategy and Clinical Outcomes

In exploratory analysis, conservative management was associated with 88% lower odds for ICU admission (OR 0.12, 95% CI 0.06–0.23; p < 0.001) and 54% reduced odds for postoperative complications (OR 0.46, 95% CI 0.27–0.77; p = 0.004) compared to surgical management. In addition, conservative treatment was associated with a 39% reduction in the odds of needing second-line therapeutic interventions (OR 0.61, 95% CI 0.37–0.99; p = 0.048) compared to surgical management. No statistically significant association was observed between conservative management and in-hospital mortality (OR 1.53, 95% CI 0.92–2.47; p = 0.092).
Endoscopic therapy was similarly associated with 81% lower odds of ICU admission compared to surgical management (OR 0.19, 95% CI 0.09–0.41; p < 0.001). However, no significant associations were identified between endoscopic treatment and the need for second-line treatment (OR 0.84, 95% CI 0.52–1.35; p = 0.49), postoperative complications (OR 1.05, 95% CI 0.61–1.85; p = 0.86), and in-hospital mortality (OR 0.50, 95% CI 0.23–0.96; p = 0.051). Table 5 summarizes the outcomes.
Table 5. Univariate analysis of clinical outcomes according to treatment strategy.

3.9. Subgroup Analysis

A subgroup analysis including studies published after 2000 (333 studies, 509 patients) was conducted to explore potential temporal changes in diagnostic and therapeutic practices (Supplementary Material, Tables S1–S3). The demographic details, anatomical distribution of perforations, and clinical presentation were broadly similar to those observed in the overall cohort. The distal esophagus remained the most frequently affected segment in 83.2% of patients, while vomiting and chest pain continued to represent the most common presenting symptoms in 80.9% and 62.8% of patients. Systemic inflammatory response syndrome was present in 192 patients (64.4%) at the time of diagnosis.
Computed tomography was the predominant diagnostic modality in 70.9% of patients. Surgical management remained the most frequent first-line treatment (59.5%), although endoscopic (21.8%) and conservative approaches (15.5%) were increasingly reported. Despite these developments, treatment strategies remained heterogeneous and clinical outcomes in the post-2000 subgroup remained comparable to those observed in the overall analysis.

3.10. Risk of Bias Assessment and Quality of Evidence

The risk of bias assessment for the included studies is presented in the Supplementary Material, Table S4. The certainty of evidence according to the GRADE framework for in-hospital mortality was rated as very low, reflecting the inclusion of case reports, imprecision of effect estimates and the potential for publication bias.

4. Discussion

BS has increasingly been managed using non-operative and minimally invasive strategies, reflecting broader shifts toward organ-preserving strategies in esophageal emergencies [5,7,9]. This systematic review and individual patient-level pooled analysis synthesizes data from 427 studies, including 694 adult patients with BS, providing, to our knowledge, the most comprehensive assessment to date of clinical presentation, management strategies, and outcomes. Consistent with the results of previous studies and despite the advent of novel therapeutic options, in-hospital mortality was 18.2%, underlining the severity of BS and the impact of SIRS at initial presentation [438,439].
The identified anatomical and clinical characteristics closely mirror patterns previously described in the literature [6,9]. The distal esophagus was affected more frequently, with a predominance of the left side. This aligns with the recognized structural vulnerability, whereby vomiting-related intraluminal pressurization and mucosal prolapse, combined with asymmetric diaphragmatic traction and reduced structural support, make the left posterolateral wall particularly susceptible to longitudinal full-thickness rupture [6,164]. Vomiting and acute chest pain remained the most frequent presenting symptoms. In addition, the wide range of abdominal and respiratory manifestations highlighted the nonspecific clinical presentation often contributing to diagnostic delays [6,255,440]. The high prevalence of SIRS at initial diagnosis underlines the rapid progression to systemic inflammation once mediastinal contamination occurs [440]. Computed tomography emerged as the predominant diagnostic modality, replacing contrast esophagography and chest x-rays. This shift reflects its superior sensitivity, ranging from 92–100%, in confirming the site of perforation, but also in delineating the extension to adjacent structures, aligning with current guideline recommendations [6,10,440]. However, the present data do not permit comparative assessment of diagnostic accuracy between imaging modalities. Future prospective studies using standardized, risk-stratified diagnostic algorithms are warranted to comparatively evaluate imaging modalities and their diagnostic accuracy across different clinical presentations of BS.
In exploratory multivariable analysis, increasing age and the presence of SIRS at diagnosis remained associated with in-hospital mortality within the available dataset. Although the multivariable analysis included 199 patients with 35 mortality events, the wide confidence interval observed for SIRS reflects substantial uncertainty in the magnitude of this association and warrants cautious interpretation. Given the case-based nature of the underlying evidence, these associations should not be interpreted as validated prognostic predictors and require confirmation in prospective and multicenter cohorts. SIRS should also be interpreted within the historical context of the included literature, as contemporary sepsis assessment has shifted toward Sepsis-3 criteria and organ dysfunction-based severity scores. Its association with mortality therefore reflects the broader physiological derangement and future prospective studies should validate these findings using contemporary severity scores. Although diagnostic delay beyond 24 h has traditionally been perceived as a prognostic indicator [6,7], this effect did not persist after adjustment, suggesting that delay is a surrogate for disease severity rather than an independent driver of mortality. In accordance with the findings of the present study, the systematic review by Vermeulen BD et al. and the multinational retrospective cohort study by Hauge T et al. also demonstrated that delayed intervention, defined as initiation of treatment more than 24 h after symptom onset, was not associated with increased mortality in patients with BS [9,438].
The present study also demonstrates the shift in the therapeutic landscape of BS [6,440]. While surgery remained the most common first-line approach, nearly one-third of patients were managed conservatively or endoscopically. In contrast to the multicenter retrospective study by Hauge T et al., which did not demonstrate significant differences in ICU length of stay between treatment strategies, in the present study, conservative and endoscopic approaches were associated with lower rates of ICU admission [9]. However, treatment allocation in BS is intrinsically dependent on clinical presentation, as these strategies are typically reserved for carefully selected patients with contained perforations, hemodynamic stability and absence of sepsis. In contrast, surgery is preferentially employed in more complex cases, including patients with extensive mediastinal contamination, hemodynamic instability, or delayed presentation [6,10]. According to Hauge et al., in-hospital mortality was comparable across the different first-line treatment approaches [9]. The absence of a statistically significant difference in mortality between treatment groups therefore cannot be interpreted as evidence of therapeutic equivalence, but these findings support the recommendations for individualized, organ-preserving management in carefully selected patients, particularly those with hemodynamic stability, contained perforations, and absence of sepsis [6,10].
The high rates of complications and need for second-line interventions across all treatment groups further highlight the complexity of managing BS [7,441]. In the present study, more than 40% of patients required escalation of therapy, reflecting both the severity of BS and the limitations of first-line treatment strategies. While endoscopic therapies have broadened the therapeutic armamentarium, the reported reintervention rates remain high, with 27% of patients requiring endoscopic procedures and 39% of patients undergoing surgical reinterventions [7]. Therefore, their effectiveness is linked to careful patient selection, local expertise, and early diagnosis, while procedure-specific complications, including stent migration, remain a significant challenge [7,10,442].
Among the limitations of this study is the inclusion of case reports and case series, which are inherently subject to selection bias, reporting bias, and incomplete data. The restriction of the search to PubMed/MEDLINE, Scopus and English-language publications may have also introduced selection bias, while inter-rater agreement for study eligibility was not formally quantified, representing an additional methodological limitation. In addition, many included cases were reported over an extended time period, during which diagnostic modalities, surgical techniques, perioperative care, and endoscopic therapies have evolved, potentially confounding outcome assessment and introducing an additional limitation. However, to address this, a subgroup analysis was performed, including studies published after 2000. Despite the comparable outcome patterns compared to the overall cohort, temporal heterogeneity cannot be fully eliminated and should be considered when interpreting the findings. Furthermore, incomplete and heterogeneous reporting across the included studies resulted in missing data and differing denominators, with available-case analysis potentially introducing additional reporting and selection bias. The heterogeneous and incomplete follow-up may have resulted in underestimation of late mortality and complications. In addition, comparisons between conservative, endoscopic, and surgical management are limited by confounding by indication and unequal baseline severity across groups, while important factors including perforation size, extent of contamination, hemodynamic status, comorbidity burden, and timing of intervention were incompletely reported and could not be adequately adjusted for, restricting causal interpretation of outcome differences. Moreover, missing data may have been non-random due to selective reporting inherent to case-based literature, potentially introducing bias into the observed associations despite available-case analysis. In this context, regression analyses were undertaken as exploratory to identify potential patient- and disease-related factors associated with adverse outcomes, which should be interpreted as hypothesis generating requiring validation in prospective studies Despite that, this study represents, to our knowledge, the largest and most comprehensive synthesis of individual patient-level data focusing exclusively on adult patients with BS, allowing detailed analysis of presentation, management, and outcomes, and providing novel insights into prognostic factors.

5. Conclusions

BS remains a rare but severe clinical condition associated with significant mortality, primarily driven by systemic inflammation at presentation. Surgery continues to be the most frequently applied treatment, although conservative and endoscopic treatment are increasingly used in carefully selected patients. In exploratory analyses, age and SIRS were associated with mortality, whereas delay to diagnosis did not display independent prognostic significance. Yet, these findings remain hypothesis-generating and require prospective validation. While recent multicenter comparative studies have begun to clarify contemporary management, further prospective collaborative studies focusing on standardized reporting and patient selection are needed to inform treatment algorithms and optimize treatment outcomes.

Supplementary Materials

The following supporting information can be downloaded at: https://www.mdpi.com/article/10.3390/jcm15187032/s1, Table S1: Demographic and clinical characteristics for studies published after 2000; Table S2: Treatment details for studies published after 2000; Table S3: Clinical Outcomes for studies published after 2000; Table S4: Risk of bias assessment using the JBI Critical Appraisal Checklist for Case Reports; PRISMA 2020 Checklist.

Author Contributions

Conceptualization, M.F. and D.S.; methodology, E.M., M.F., N.T., A.M., A.S. and N.D.; software, M.F.; validation, E.M.; formal analysis, E.M., D.D. and N.K.; investigation, M.F. and G.T.; writing—original draft preparation, E.M., M.F., N.T., A.M., M.D. and A.S.; writing—review and editing, E.M., M.F., D.D., N.D., G.T. and D.S.; supervision, D.S.; project administration, D.S. All authors have read and agreed to the published version of the manuscript.

Funding

This research received no external funding.

Institutional Review Board Statement

Ethical review and approval were not required because this study is a systematic review based exclusively on data extracted from previously published studies and does not involve human participants or identifiable individual patient data.

Data Availability Statement

The individual patient-level dataset extracted from the included published reports and used for the present analyses is available from the corresponding author upon reasonable request.

Conflicts of Interest

The authors declare no conflicts of interest.

Abbreviations

The following abbreviations are used in this manuscript:
BSBoerhaave’s syndrome
EVTEndoscopic vacuum therapy
ICUIntensive care unit
SDStandard deviation
IQRInterquartile range
OROdds ratio
SIRSSystemic inflammatory response syndrome
CTComputed tomography

References

  1. Vidarsdottir, H.; Blondal, S.; Alfredsson, H.; Geirsson, A.; Gudbjartsson, T. Oesophageal perforations in Iceland: A whole population study on incidence, aetiology and surgical outcome. Thorac. Cardiovasc. Surg. 2010, 58, 476–480. [Google Scholar] [CrossRef] [Scilit]
  2. Mackler, S.A. Spontaneous rupture of the esophagus; an experimental and clinical study. Surg. Gynecol. Obs. 1952, 95, 345–356. [Google Scholar]
  3. Derbes, V.J.; Mitchell, R.E., Jr. Hermann Boerhaave’s Atrocis, nec descripti prius, morbi historia, the first translation of the classic case report of rupture of the esophagus, with annotations. Bull. Med. Libr. Assoc. 1955, 43, 217–240. [Google Scholar]
  4. Barrett, N.R. Report of a case of spontaneous perforation of the oesophagus successfully treated by operation. Br. J. Surg. 1947, 35, 216–218. [Google Scholar] [CrossRef] [Scilit]
  5. Brinster, C.J.; Singhal, S.; Lee, L.; Marshall, M.B.; Kaiser, L.R.; Kucharczuk, J.C. Evolving options in the management of esophageal perforation. Ann. Thorac. Surg. 2004, 77, 1475–1483. [Google Scholar] [CrossRef] [Scilit]
  6. Hauge, T.; Abu Hejleh, A.; Nilsson, M.; Schröder, W. Boerhaave syndrome. Br. J. Surg. 2024, 111, znae216. [Google Scholar] [CrossRef] [Scilit]
  7. Margaris, I.; Triantafyllou, T.; Sidiropoulos, T.A.; Sideris, G.; Theodorou, D.; Arkadopoulos, N.; Michalopoulos, N.V. Efficacy of esophageal stents as a primary therapeutic option in spontaneous esophageal perforations: A systematic review and meta-analysis of observational studies. Ann. Gastroenterol. 2024, 37, 156–171. [Google Scholar] [CrossRef] [Scilit]
  8. Luttikhold, J.; Pattynama, L.M.D.; Seewald, S.; Groth, S.; Morell, B.K.; Gutschow, C.A.; Ida, S.; Nilsson, M.; Eshuis, W.J.; Pouw, R.E. Endoscopic vacuum therapy for esophageal perforation: A multicenter retrospective cohort study. Endoscopy 2023, 55, 859–864. [Google Scholar] [CrossRef] [Scilit]
  9. Hauge, T.; Abu Hejleh, A.; Aiolfi, A.; Berlth, F.; Bonavina, L.; Brake, L.; Conradi, L.C.; D’Journo, X.B.; Edholm, D.; Elliot, J.; et al. Treatment strategies for Boerhaave syndrome: Multinational retrospective cohort study. Br. J. Surg. 2025, 112, znaf260. [Google Scholar] [CrossRef] [Scilit]
  10. Chirica, M.; Kelly, M.D.; Siboni, S.; Aiolfi, A.; Riva, C.G.; Asti, E.; Ferrari, D.; Leppäniemi, A.; Ten Broek, R.P.G.; Brichon, P.Y.; et al. Esophageal emergencies: WSES guidelines. World J. Emerg. Surg. 2019, 14, 26. [Google Scholar] [CrossRef] [Scilit]
  11. Page, M.J.; McKenzie, J.E.; Bossuyt, P.M.; Boutron, I.; Hoffmann, T.C.; Mulrow, C.D.; Shamseer, L.; Tetzlaff, J.M.; Akl, E.A.; Brennan, S.E.; et al. The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. BMJ 2021, 372, n71. [Google Scholar] [CrossRef] [Scilit]
  12. Moola, S.; Munn, Z.; Tufanaru, C.; Aromataris, E.; Sears, K.; Sfetcu, R.; Currie, M.; Qureshi, R.; Mattis, P.; Lisy, K.; et al. Chapter 7: Systematic reviews of etiology and risk. In Joanna Briggs Institute Reviewer’s Manual; Aromataris, E., Munn, Z., Eds.; The Joanna Briggs Institute: North Adelaide, Australia, 2020; Available online: https://jbi-global-wiki.refined.site/space/MANUAL/355863557/Previous+versions?attachment=/download/attachments/355863557/JBI_Reviewers_Manual_2020June.pdf&type=application/pdf&filename=JBI_Reviewers_Manual_2020June.pdf#page=217/ (accessed on 30 June 2026).
  13. Brozek, J.L.; Canelo-Aybar, C.; Akl, E.A.; Bowen, J.M.; Bucher, J.; Chiu, W.A.; Cronin, M.; Djulbegovic, B.; Falavigna, M.; Guyatt, G.H.; et al. GRADE Guidelines 30: The GRADE approach to assessing the certainty of modeled evidence-An overview in the context of health decision-making. J. Clin. Epidemiol. 2021, 129, 138–150. [Google Scholar] [CrossRef] [Scilit]
  14. Vest, M.T.; Dross, P. Boerhaave Syndrome. J. Am. Osteopat. Assoc. 2018, 118, 764. [Google Scholar] [CrossRef] [Scilit]
  15. Pinto, M.J.F.; Rodrigues, P.; Almeida, L.; Leitão, A.; Flores, L.; Gomes, A.; Rocha, G.; Friões, F. Boerhaave Syndrome in an Elderly Man. Eur. J. Case Rep. Intern. Med. 2018, 5, 000944. [Google Scholar] [CrossRef] [Scilit]
  16. He, X.; He, Z.; Li, H. Boerhaave syndrome: Challenges in diagnosis and treatment of the early presentation and its complication. J. Trauma. Acute Care Surg. 2018, 84, 1030–1032. [Google Scholar] [CrossRef] [Scilit]
  17. Pasternak, A.; Ellero, J.; Maxwell, S.; Cheung, V. Boerhaave’s syndrome in an ultra-distance runner. BMJ Case Rep. 2019, 12, e230343. [Google Scholar] [CrossRef] [Scilit]
  18. Chen, A.; Kim, R. Boerhaave syndrome treated with endoscopic suturing. VideoGIE 2019, 4, 118–119. [Google Scholar] [CrossRef] [Scilit]
  19. Ahmad, W.; Kwong, W.T. Boerhaave’s Syndrome: A Window to the Heart. Clin. Gastroenterol. Hepatol. 2018, 16, e77–e78. [Google Scholar] [CrossRef] [Scilit]
  20. Vaidya, S.; Prabhudessai, S.; Jhawar, N.; Patankar, R.V. Boerhaave’s syndrome: Thoracolaparoscopic approach. J. Minimal Access Surg. 2010, 6, 76–79. [Google Scholar] [CrossRef] [Scilit]
  21. Cameron, J.L.; Kieffer, R.F.; Hendrix, T.R.; Mehigan, D.G.; Baker, R.R. Selective nonoperative management of contained intrathoracic esophageal disruptions. Ann. Thorac. Surg. 1979, 27, 404–408. [Google Scholar] [CrossRef] [Scilit]
  22. Szeliga, J.; Jackowski, M. Boerhaave syndrome. Pol. Przegl. Chir. 2011, 83, 523–526. [Google Scholar] [CrossRef] [Scilit]
  23. Ferreiro-Iglesias, R.; Blanco Freire, M.N.; Paz Novo, M.; Domínguez Muñoz, J.E. Boerhaave’s syndrome: Diagnostic gastroscopy. Rev. Esp. Enferm. Dig. 2017, 109, 65–66. [Google Scholar]
  24. Lieu, M.T.; Layoun, M.E.; Dai, D.; Soo Hoo, G.W.; Betancourt, J. Tension hydropneumothorax as the initial presentation of Boerhaave syndrome. Respir. Med. Case Rep. 2018, 25, 100–103. [Google Scholar] [CrossRef] [Scilit]
  25. Chalikonda, D.; Yoo, J.; Johnson, D.; Tofani, C. Boerhaave Syndrome Causing Bilateral Empyemas. ACG Case Rep. J. 2019, 6, e00203. [Google Scholar] [CrossRef] [Scilit]
  26. Dinic, B.R.; Ilic, G.; Rajkovic, S.T.; Stoimenov, T.J. Boerhaave syndrome—Case report. Sao Paulo Med. J. 2017, 135, 71–75. [Google Scholar] [CrossRef] [Scilit]
  27. Al-Zahir, A.A.; AlSaif, O.H.; AlNaimi, M.M.; Almomen, S.A.M.; Meshikhes, A.N. Boerhaave’s Syndrome: Delayed Management Using Over-the-Scope Clip. Am. J. Case Rep. 2019, 20, 816–821. [Google Scholar] [CrossRef] [Scilit]
  28. Yap, D.; Ng, M.; Mbakada, N. A rare complication of ileostomy obstruction: Boerhaave syndrome. Ann. R. Coll. Surg. Engl. 2018, 100, e1–e4. [Google Scholar] [CrossRef] [Scilit]
  29. Olivero, R. Boerhaave syndrome: A rare postoperative complication. JAAPA 2019, 32, 1–3. [Google Scholar] [CrossRef] [Scilit]
  30. Bayram, A.S.; Erol, M.M.; Melek, H.; Colak, M.A.; Kermenli, T.; Gebitekin, C. The success of surgery in the first 24 hours in patients with esophageal perforation. Eurasian J. Med. 2015, 47, 41–47. [Google Scholar] [CrossRef] [Scilit]
  31. Swol, J.; Ficker, J.H.; Mannke, B. Cervical Emphysema in Boerhaave Syndrome. Dtsch. Arztebl. Int. 2019, 116, 211. [Google Scholar] [CrossRef] [Scilit]
  32. Ekladious, A.; Tiong, M.K. Boerhaave syndrome: A common manifestation of a rare disease. Intern. Med. J. 2018, 48, 222–223. [Google Scholar] [CrossRef] [Scilit]
  33. Ali, D.; Detroz, A.; Gorur, Y.; Bosquée, L.; Cardos, B.; Cobanoiu, C.; Villalba, N.L. Abrupt Severe Chest Pain and Vomiting: Remember to Think of a Ruptured Oesophagus (Boerhaave Syndrome). Eur. J. Case Rep. Intern. Med. 2019, 6, 001265. [Google Scholar] [CrossRef] [Scilit]
  34. Kim, Y.E.; Do, Y.W.; Cho, J.Y.; Kim, E.S.; Lee, D.H. Successful Treatment Using Endoluminal Vacuum Therapy after Failure of Primary Closure in Boerhaave Syndrome. Korean J. Gastroenterol. 2019, 73, 219–224. [Google Scholar] [CrossRef] [Scilit]
  35. Atie, M.; Dunn, G.; Falk, G.L. Delayed presentation of Boerhaave’s syndrome. BMJ Case Rep. 2016, 2016, bcr2016217391. [Google Scholar] [CrossRef] [Scilit]
  36. Teblick, A.; Jansens, H.; Dams, K.; Somville, F.J.; Jorens, P.G. Boerhaave’s syndrome complicated by a Saccharomyces cerevisiae pleural empyema. Case report and review of the literature. Acta Clin. Belg. 2018, 73, 377–381. [Google Scholar] [CrossRef] [Scilit]
  37. Emmanouilidis, N.; Jäger, M.D.; Winkler, M.; Klempnauer, J. Boerhaave syndrome as a complication of colonoscopy preparation: A case report. J. Med. Case Rep. 2011, 5, 544. [Google Scholar] [CrossRef] [Scilit]
  38. Cuccì, M.; Caputo, F.; Fraternali Orcioni, G.; Roncallo, A.; Ventura, F. Transition of a Mallory-Weiss syndrome to a Boerhaave syndrome confirmed by anamnestic, necroscopic, and autopsy data: A case report. Medicine 2018, 97, e13191. [Google Scholar] [CrossRef] [Scilit]
  39. Kopelman, Y.; Abu Baker, F.; Troiza, A.; Hebreon, D. Boerhaave syndrome in an elderly man successfully treated with 3-month indwelling esophageal stent. Radiol. Case Rep. 2018, 13, 1084–1086. [Google Scholar] [CrossRef] [Scilit]
  40. Lucendo, A.J.; Friginal-Ruiz, A.B.; Rodríguez, B. Boerhaave’s syndrome as the primary manifestation of adult eosinophilic esophagitis. Two case reports and a review of the literature. Dis. Esophagus 2011, 24, E11–E15. [Google Scholar] [CrossRef] [Scilit]
  41. Shemesh, A.; Taub, C.C. Inferolateral ST-segment Elevation in Boerhaave Syndrome. Am. J. Med. 2016, 129, e27–e28. [Google Scholar] [CrossRef] [Scilit]
  42. Aref, H.; Yunus, T.; Alhallaq, O. Laparoscopic Management of Boerhaave’s syndrome: A case report with an intraoperative video. BMC Surg. 2019, 19, 109. [Google Scholar] [CrossRef] [Scilit]
  43. Okamoto, H.; Onodera, K.; Kamba, R.; Taniyama, Y.; Sakurai, T.; Heishi, T.; Teshima, J.; Hikage, M.; Sato, C.; Maruyama, S.; et al. Treatment of spontaneous esophageal rupture (Boerhaave syndrome) using thoracoscopic surgery and sivelestat sodium hydrate. J. Thorac. Dis. 2018, 10, 2206–2212. [Google Scholar] [CrossRef] [Scilit]
  44. Anwar, J.; Maqsood, R.; Soomro, S. Multimodality Imaging Approach For The Early Diagnosis Boerhaave Syndrome. J. Ayub Med. Coll. Abbottabad 2017, 29, 157–158. [Google Scholar]
  45. Carrozza, F.; Dragean, C. Spontaneous Esophageal Rupture or Boerhaave’s Syndrome. J. Belg. Soc. Radiol. 2020, 104, 1. [Google Scholar] [CrossRef] [Scilit]
  46. Chae, R.P.; Johnson, M.A.; Robinson, D.; Hii, M.W. Aorto-oesophageal fistula: A late complication of Boerhaave syndrome. BMJ Case Rep. 2019, 12, e228885. [Google Scholar] [CrossRef] [Scilit]
  47. Vallabhajosyula, S.; Sundaragiri, P.R.; Berim, I.G. Boerhaave Syndrome Presenting as Tension Pneumothorax. J. Intensive Care Med. 2016, 31, 349–352. [Google Scholar] [CrossRef] [Scilit]
  48. Ibrahim-Zada, I.; Ernest, P.; Moore, E.E. Intrathoracic transmural esophageal perforation (Boerhaave’s syndrome): Challenges in management of the delayed presentation. J. Trauma Acute Care Surg. 2018, 85, 644–645. [Google Scholar] [CrossRef] [Scilit]
  49. James, T.W.; Brimhall, B.B.; Baron, T.H. Use of multiple covered metal esophageal stents for treatment of Boerhaave syndrome in achalasia. VideoGIE 2019, 4, 549–550. [Google Scholar] [CrossRef] [Scilit]
  50. Kanzaki, R.; Yano, M.; Motoori, M.; Kishi, K.; Miyashiro, I.; Yoshino, K.; Tomita, Y.; Ishikawa, O. Boerhaave’s syndrome in a tracheoesophageal speaker: Report of a case. Surg. Today 2014, 44, 1569–1572. [Google Scholar] [CrossRef] [Scilit]
  51. Tzeng, C.H.; Chen, W.K.; Lu, H.C.; Chen, H.H.; Lee, K.I.; Wu, Y.S.; Lee, F.Y. Challenges in the diagnosis of Boerhaave syndrome: A case report. Medicine 2020, 99, e18765. [Google Scholar] [CrossRef] [Scilit]
  52. Barakat, M.T.; Girotra, M.; Banerjee, S. (Re)building the Wall: Recurrent Boerhaave Syndrome Managed by Over-the-Scope Clip and Covered Metallic Stent Placement. Dig. Dis. Sci. 2018, 63, 1139–1142. [Google Scholar] [CrossRef] [Scilit]
  53. Kincaid, K.; Ramirez, E.G. Esophageal rupture: Boerhaave syndrome. Crit. Care Nurs. Q. 2012, 35, 196–202. [Google Scholar] [CrossRef] [Scilit]
  54. Ishikawa, Y.; Tagami, T.; Hirashima, H.; Fukuda, R.; Moroe, Y.; Unemoto, K. Endoscopic Treatment of Boerhaave Syndrome Using Polyglycolic Acid Sheets and Fibrin Glue: A Report of Two Cases. J. Nippon Med. Sch. 2017, 84, 241–245. [Google Scholar] [CrossRef] [Scilit]
  55. Ijaz, M.; Rafiq, A.; Venkatram, S.; Diaz-Fuentes, G. Boerhaave Syndrome, Pneumothorax, and Chylothorax in a Critically Ill Patient with Tuberous Sclerosis Complex. Case Rep. Crit. Care 2015, 2015, 509094. [Google Scholar] [CrossRef] [Scilit]
  56. Tonolini, M.; Bianco, R. Spontaneous esophageal perforation (Boerhaave syndrome): Diagnosis with CT-esophagography. J. Emerg. Trauma. Shock 2013, 6, 58–60. [Google Scholar] [CrossRef] [Scilit]
  57. Bona, D.; Aiolfi, A.; Rausa, E.; Bonavina, L. Management of Boerhaave’s syndrome with an over-the-scope clip. Eur. J. Cardiothorac. Surg. 2014, 45, 752–754. [Google Scholar] [CrossRef] [Scilit]
  58. Gupta, R.K.; Sah, P.L.; Sah, S.; Sapkota, S. Atypical presentation of Boerhaave’s syndrome. BMJ Case Rep. 2012, 2012, bcr2012006368. [Google Scholar] [CrossRef] [Scilit]
  59. De Groote, K.; Leys, M.; Verhamme, M. Unilateral pleural effusion revealing boerhaave’s syndrome. Acta Clin. Belg. 2013, 68, 449–450. [Google Scholar] [CrossRef] [Scilit]
  60. Yagnik, V.D. Boerhaave syndrome. ANZ J. Surg. 2010, 80, 756. [Google Scholar] [CrossRef] [Scilit]
  61. Suzuki, M.; Sato, N.; Matsuda, J.; Niwa, N.; Murai, K.; Yamamoto, T.; Takeda, S.; Shigehara, K.; Nomura, T.; Gamma, A.; et al. A case of rapid diagnosis of Boerhaave syndrome by thoracic drainage. J. Emerg. Med. 2012, 43, e419–e423. [Google Scholar] [CrossRef] [Scilit]
  62. Paily, A.; Patel, D.; Lamb, P. Boerhaave’s syndrome secondary to gastric volvulus. Scott. Med. J. 2012, 57, 121. [Google Scholar] [CrossRef] [Scilit]
  63. Barnett, D.; Kinnear, N.; Yao, H.H.; Chee, J. Renal colic causing Boerhaave syndrome. Transl. Androl. Urol. 2020, 9, 828–830. [Google Scholar] [CrossRef] [Scilit]
  64. Davies, J.; Spitzer, D.; Phylactou, M.; Glasser, M. Cardiac arrest due to a missed diagnosis of Boerhaave’s syndrome. BMJ Case Rep. 2016, 2016, bcr2014208659. [Google Scholar] [CrossRef] [Scilit]
  65. Anwuzia-Iwegbu, C.; Al Omran, Y.; Heaford, A. Against all odds. Conservative management of Boerhaave’s syndrome. BMJ Case Rep. 2014, 2014, bcr2013200485. [Google Scholar] [CrossRef] [Scilit]
  66. Musala, C.; Eisendrath, P.; Brasseur, A.; Vincent, J.L.; Cappeliez, S.; Le Moine, O.; Devière, J.; Lemmers, A. Successful treatment of Boerhaave syndrome with an over-the-scope clip. Endoscopy 2015, 47, E24–E25. [Google Scholar] [CrossRef] [Scilit]
  67. Dichtl, K.; Koeppel, M.B.; Wallner, C.P.; Marx, T.; Wagener, J.; Ney, L. Food poisoning: An underestimated cause of Boerhaave syndrome. Infection 2020, 48, 125–128. [Google Scholar] [CrossRef] [Scilit]
  68. Lee, W.; Siau, K.; Singh, G. Boerhaave’s syndrome presenting as an upper gastrointestinal bleed. BMJ Case Rep. 2013, 2013, bcr2013201267. [Google Scholar] [CrossRef] [Scilit]
  69. Tamatey, M.N.; Sereboe, L.A.; Tettey, M.M.; Entsua-Mensah, K.; Gyan, B. Boerhaave’s syndrome: Diagnosis and successful primary repair one month after the oesophageal perforation. Ghana Med. J. 2013, 47, 53–55. [Google Scholar]
  70. Kimura-Kataoka, K.; Fujihara, J.; Kurata, S.; Takinami, Y.; Inoue, K.; Yasuda, T.; Takeshita, H. An autopsy case of spontaneous esophageal perforation (Boerhaave syndrome). Leg. Med. 2016, 23, 5–9. [Google Scholar] [CrossRef] [Scilit]
  71. Oh, M.K.; Jeon, W.J.; Cho, S.Y.; Kwon, Y.D.; Kim, K.H. Development of bilateral tension pneumothorax under anesthesia in a Boerhaave’s syndrome patient: A case report. Korean J. Anesth. 2016, 69, 175–180. [Google Scholar] [CrossRef] [Scilit]
  72. Ramhamadany, E.; Mohamed, S.; Jaunoo, S.; Baker, T.; Mannath, J.; Harding, J.; Menon, V. A delayed presentation of Boerhaave’s syndrome with mediastinitis managed using the over-the-scope clip. J. Surg. Case Rep. 2013, 2013, rjt020. [Google Scholar] [CrossRef] [Scilit]
  73. Lakshmanadoss, U.; Mogili, S.; Kothari, T.; Das, V. Migration of the chest tube into the esophagus in a case of Boerhaave’s syndrome. Heart Lung 2011, 40, 576–579. [Google Scholar] [CrossRef] [Scilit]
  74. Czopnik, P.; Aporowicz, M.; Niepokój-Czopnik, A.; Szajerka, T.; Domosławski, P. Barogenic rupture of esophagus (Boerhaave syndrome) as diagnostic and therapeutic challenge requiring rapid and effective interdisciplinary cooperation—Case report. Pol. Przegl. Chir. 2017, 89, 37–39. [Google Scholar] [CrossRef] [Scilit]
  75. González-Haba, M.; Ferguson, M.K.; Gelrud, A. Spontaneous esophageal perforation (Boerhaave syndrome) successfully treated with an over-the-scope clip and fully covered metal stent. Gastrointest. Endosc. 2016, 83, 650. [Google Scholar] [CrossRef] [Scilit]
  76. Shen, G.; Chai, Y.; Zhang, G.F. Successful surgical strategy in a late case of Boerhaave’s syndrome. World J. Gastroenterol. 2014, 20, 12696–12700. [Google Scholar] [CrossRef] [Scilit]
  77. Kobara, H.; Mori, H.; Rafiq, K.; Fujihara, S.; Nishiyama, N.; Kato, K.; Oryu, M.; Tani, J.; Miyoshi, H.; Masaki, T. Successful endoscopic treatment of Boerhaave syndrome using an over-the-scope clip. Endoscopy 2014, 46, E82–E83. [Google Scholar] [CrossRef] [Scilit]
  78. Ganguly, A.; Porwal, M.; Khandeparkar, J. Boerhaave’s syndrome: Experience with patients presenting later than 24 hours. Trop. Gastroenterol. 2015, 36, 188–191. [Google Scholar] [CrossRef] [Scilit]
  79. Vinnamala, S.; Menon, V.; Arasaradnam, R.; Eaden, J.A.; Wong, J.L.; Mannath, J. Endoscopic closure of acute Boerhaave’s syndrome with an over-the-scope clip. Endoscopy 2014, 46, E481–E482. [Google Scholar] [CrossRef] [Scilit]
  80. Van Weyenberg, S.J.; Stam, F.J.; Marsman, W. Successful endoscopic closure of spontaneous esophageal rupture (Boerhaave syndrome). Gastrointest. Endosc. 2014, 80, 162. [Google Scholar] [CrossRef] [Scilit]
  81. Salvador Baudet, J.; Arencibia, A.; Soler, M.; Redondo, I.; Hernández, G. Spontaneous esophageal rupture (Boerhaave’s syndrome). An uncommon image. Rev. Esp. Enferm. Dig. 2011, 103, 482–483. [Google Scholar] [CrossRef] [Scilit]
  82. O’Kelly, F.; Lim, K.T.; Cooke, F.; Ravi, N.; Reynolds, J.V. An unusual presentation of Boerhaave Syndrome: A case report. Cases J. 2009, 2, 8000. [Google Scholar] [CrossRef] [Scilit]
  83. Kimberley, K.L.; Ganesh, R.; Anton, C.K. Laparoscopic repair of esophageal perforation due to Boerhaave syndrome. Surg. Laparosc. Endosc. Percutan. Tech. 2011, 21, e203–e205. [Google Scholar] [CrossRef] [Scilit]
  84. Zimmer, V. Salvage Intraluminal Endoscopic Vacuum Therapy for Stent Failure in Late-Presenting Boerhaave Syndrome. Clin. Gastroenterol. Hepatol. 2021, 19, A32. [Google Scholar] [CrossRef] [Scilit]
  85. Kundra, M.; Yousaf, S.; Maqbool, S.; Mahajan, P.V. Boerhaave syndrome—Unusual cause of chest pain. Pediatr. Emerg. Care 2007, 23, 489–491. [Google Scholar] [CrossRef] [Scilit]
  86. Larrieu, A.J.; Kieffer, R. Boerhaave syndrome: Report of a case treated non-operatively. Ann. Surg. 1975, 181, 452–454. [Google Scholar] [CrossRef] [Scilit]
  87. Loske, G.; Schorsch, T.; van Ackeren, V.; Schulze, W.; Müller, C.T. Endoscopic vacuum therapy in Boerhaave’s syndrome with open-pore polyurethane foam and a new open-pore film drainage. Endoscopy 2015, 47, E410–E411. [Google Scholar] [CrossRef] [Scilit]
  88. Naitoh, H.; Fukuchi, M.; Kiriyama, S.; Fukasawa, T.; Tabe, Y.; Yamauchi, H.; Yoshida, T.; Saito, K.; Hagiwara, K.; Kuwano, H. Recurrent, spontaneous esophageal ruptures associated with antiphospholipid antibody syndrome: Report of a case. Int. Surg. 2014, 99, 842–845. [Google Scholar] [CrossRef] [Scilit]
  89. Ng, C.S.; Mui, W.L.; Yim, A.P. Barogenic esophageal rupture: Boerhaave syndrome. Can. J. Surg. 2006, 49, 438–439. [Google Scholar]
  90. Keane, M.; Gowripalann, T.; Brodbeck, A.; Bothma, P. A lesson in clinical findings, diagnosis, reassessment and outcome: Boerhaave’s syndrome. BMJ Case Rep. 2012, 2012, bcr2012006485. [Google Scholar] [CrossRef] [Scilit]
  91. Barbara, D.W.; Smith, B.C.; Hartman, W.R. Boerhaave’s syndrome: Spontaneous esophageal rupture. Anesthesiology 2012, 117, 1127. [Google Scholar] [CrossRef] [Scilit]
  92. Henderson, J.A.; Péloquin, A.J. Boerhaave revisited: Spontaneous esophageal perforation as a diagnostic masquerader. Am. J. Med. 1989, 86, 559–567. [Google Scholar] [CrossRef] [Scilit]
  93. Korczynski, P.; Krenke, R.; Fangrat, A.; Kupis, W.; Orlowski, T.M.; Chazan, R. Acute respiratory failure in a patient with spontaneous esophageal rupture (Boerhaave syndrome). Respir. Care 2011, 56, 347–350. [Google Scholar] [CrossRef] [Scilit]
  94. Neff, C.; Lawson, D.W. Boerhaave syndrome: Interventional radiologic management. AJR Am. J. Roentgenol. 1985, 145, 819–820. [Google Scholar] [CrossRef] [Scilit]
  95. Ivey, T.D.; Simonowitz, D.A.; Dillard, D.H.; Miller, D.W., Jr. Boerhaave syndrome. Successful conservative management in three patients with late presentation. Am. J. Surg. 1981, 141, 531–533. [Google Scholar] [CrossRef] [Scilit]
  96. Blencowe, N.S.; Strong, S.; Hollowood, A.D. Spontaneous oesophageal rupture. BMJ 2013, 346, f3095. [Google Scholar] [CrossRef] [Scilit]
  97. Ho, A.F.W.; Pek, P.P.; Toh, H.C. Man with back pain and fever. Can. J. Emerg. Med. 2018, 20, 313–314. [Google Scholar] [CrossRef] [Scilit]
  98. Fernandes, S.; Noronha-Ferreira, C.; Freire, J.; Velosa, J. An unusual cause of Boerhaave’s syndrome in a young patient. Rev. Esp. Enferm. Dig. 2017, 109, 376–377. [Google Scholar]
  99. Paluszkiewicz, P.; Bartosinski, J.; Rajewska-Durda, K.; Krupinska-Paluszkiewicz, K. Cardiac arrest caused by tension pneumomediastinum in a Boerhaave syndrome patient. Ann. Thorac. Surg. 2009, 87, 1257–1258. [Google Scholar] [CrossRef] [Scilit]
  100. Matsuda, A.; Miyashita, M.; Sasajima, K.; Nomura, T.; Makino, H.; Matsutani, T.; Katsuno, A.; Sasaki, J.; Tajiri, T. Boerhaave syndrome treated conservatively following early endoscopic diagnosis: A case report. J. Nippon Med. Sch. 2006, 73, 341–345. [Google Scholar] [CrossRef] [Scilit]
  101. Thapa, A.S.; Thapa, B.; Shakya, Y. Delayed presentation and diagnosis of Boerhaave’s syndrome. Emerg. Med. Australas. 2014, 26, 201–202. [Google Scholar] [CrossRef] [Scilit]
  102. Dżeljilji, A.; Rokicki, W.; Rokicki, M. A rare case of duodenal ulcer perforation accompanied by Boerhaave syndrome. Kardiochir. Torakochir. Pol. 2015, 12, 262–265. [Google Scholar] [CrossRef] [Scilit]
  103. Shiber, J.R.; Fontane, E.; Ra, J.H.; Kerwin, A.J. Hydropneumothorax Due to Esophageal Rupture. J. Emerg. Med. 2017, 52, 856–858. [Google Scholar] [CrossRef] [Scilit]
  104. Bruno, M.S.; Grier, W.R.; Ober, W.B. Spontaneous laceration and rupture of esophagus and stomach. Mallory-weiss syndrome, boerhaave syndrome, and their variants. Arch. Intern. Med. 1963, 112, 574–583. [Google Scholar] [CrossRef] [Scilit]
  105. Clément, R.; Bresson, C.; Rodat, O. Spontaneous oesophageal perforation. J. Clin. Forensic Med. 2006, 13, 353–355. [Google Scholar] [CrossRef] [Scilit]
  106. Grau Pérez, M.; Aguilar Mulet, J.M.; Santiago Poveda, C. Left hydropneumothorax in a patient with acute epigastric pain: An important clue! Intern. Emerg. Med. 2018, 13, 133–134. [Google Scholar] [CrossRef] [Scilit]
  107. Wilson, D.R.; Cotie, R.W.; Bailey, L.L. Boerhaave syndrome: Lifters’ liability. West. J. Med. 1980, 133, 517–519. [Google Scholar]
  108. Sato, H.; Ishida, K.; Sasaki, S.; Kojika, M.; Endo, S.; Inoue, Y.; Sasaki, A. Regulating migration of esophageal stents—Management using a Sengstaken-Blakemore tube: A case report and review of literature. World J. Gastroenterol. 2018, 24, 3192–3197. [Google Scholar] [CrossRef] [Scilit]
  109. Nitta, J.; Adachi, K. Sudden chest pain. Gastroenterology 2014, 146, e11–e12. [Google Scholar] [CrossRef] [Scilit]
  110. Gurvits, G.E. Education and imaging. Gastrointestinal: “Walk in the snow”: Boerhaave syndrome. J. Gastroenterol. Hepatol. 2011, 26, 207. [Google Scholar] [CrossRef] [Scilit]
  111. Callaghan, J. The Boerhaave syndrome (spontaneous rupture of the oesophagus). Br. J. Surg. 1972, 59, 41–44. [Google Scholar] [CrossRef] [Scilit]
  112. Han, N.J.; Silva, A.C.; Decker, G.A. Esophageal rupture: Computed tomography with endoscopic correlation. Radiol. Case Rep. 2015, 8, 433. [Google Scholar] [CrossRef] [Scilit]
  113. Kim, J.H.; Park, J.J.; Jung, I.W.; Kim, S.H.; Kim, H.D.; Choe, J.W.; Joo, M.K.; Kim, H.G. Treatment of Traumatic Esophagopleural Fistula Using the Over-the-Scope-Clip System. Clin. Endosc. 2015, 48, 440–443. [Google Scholar] [CrossRef] [Scilit]
  114. Ng, P. An unusual case of chest pain. BMJ Case Rep. 2013, 2013, bcr2013008849. [Google Scholar] [CrossRef] [Scilit]
  115. Arens, A.; Ben-Youssef, L.; Hayashi, S.; Smollin, C. Esophageal Rupture After Ghost Pepper Ingestion. J. Emerg. Med. 2016, 51, e141–e143. [Google Scholar] [CrossRef] [Scilit]
  116. Do, Y.W.; Lee, C.Y.; Lee, S.; Kim, H.E.; Kim, B.J.; Lee, J.G. Successful Management of Delayed Esophageal Rupture with T-Tube Drainage Using Video-Assisted Thoracoscopic Surgery. Korean J. Thorac. Cardiovasc. Surg. 2016, 49, 478–480. [Google Scholar] [CrossRef] [Scilit]
  117. Li, A.; Fan, K.; Ng, P.; Yip, H.S. Gastrointestinal: Not just a simple pneumothorax. J. Gastroenterol. Hepatol. 2016, 31, 284. [Google Scholar] [CrossRef] [Scilit]
  118. Rodríguez-Infante, A.; Granero-Castro, P.; Alvarez-Pérez, J.A.; Turienzo-Santos, E.; Vázquez-Velasco, L. Atypical localization in Boerhaave’s syndrome. Rev. Esp. Enferm. Dig. 2012, 104, 555–557. [Google Scholar] [CrossRef] [Scilit]
  119. Johnson, H.M.; Anciano, C.J.; Laks, S. Esophageal perforation secondary to malignant gastric outlet obstruction: A case report. World J. Surg. Oncol. 2019, 17, 36. [Google Scholar] [CrossRef] [Scilit]
  120. Cayci, H.M.; Erdoğdu, U.E.; Dilektasli, E.; Turkoglu, M.A.; Firat, D.; Cantay, H. An unusual approach for the treatment of oesophageal perforation: Laparoscopic-endoscopic cooperative surgery. J. Minimal Access Surg. 2017, 13, 69–72. [Google Scholar] [CrossRef] [Scilit]
  121. delCastillo, J.; Boyar, C.; Hess, F.; Miller, J. Atraumatic panmural rupture of the esophagus: Boerhaave syndrome. Ann. Emerg. Med. 1983, 12, 385–390. [Google Scholar] [CrossRef] [Scilit]
  122. Humphreys, M.L.; Jenkins, B.; Robertson, J.; Rodgers, M. Spontaneous oesophageal perforation after laparoscopic hiatus hernia repair. ANZ J. Surg. 2015, 85, 887–888. [Google Scholar] [CrossRef] [Scilit]
  123. Chapman, T.P.; Gorard, D.A.; Johns, E.A. An unusual cause of chest pain. Gastroenterology 2012, 143, 1438, 1692. [Google Scholar] [CrossRef] [Scilit]
  124. Beason, H.F.; Markowitz, J.E. Pneumomediastinum Diagnosed on Ultrasound in the Emergency Department: A Case Report. Perm. J. 2015, 19, e122–e124. [Google Scholar] [CrossRef] [Scilit]
  125. Ngo, E.; Born, P.; Strebel, H. Endoscopic treatment of an oesophageal rupture using an over-the-scope clip (OTSC): A case report. Arab. J. Gastroenterol. 2015, 16, 139–141. [Google Scholar] [CrossRef] [Scilit]
  126. Ashrafian, H.; Navarro-Sanchez, A.; Athanasiou, T.; Sherman, D.I.; Isla, A. Thoracoscopic esophageal repair of a spontaneous Barrett’s ulcer perforation. Ann. Thorac. Surg. 2015, 99, 331–333. [Google Scholar] [CrossRef] [Scilit]
  127. Wu, G.; Zhao, Y.S.; Fang, Y.; Qi, Y.; Li, X.; Jiao, D.; Ren, K.; Han, X. Treatment of spontaneous esophageal rupture with transnasal thoracic drainage and temporary esophageal stent and jejunal feeding tube placement. J. Trauma. Acute Care Surg. 2017, 82, 141–149. [Google Scholar] [CrossRef] [Scilit]
  128. Ghassemi, K.F.; Rodriguez, H.J.; Vesga, L.; Stewart, L.; McQuaid, K.R.; Shah, J.N. Endoscopic treatment of Boerhaave syndrome using a removable self-expandable plastic stent. J. Clin. Gastroenterol. 2007, 41, 863–864. [Google Scholar] [CrossRef] [Scilit]
  129. Nensa, F.; Stylianou, E.; Schroeder, T. Progressive dyspnea after a heavy coughing attack. Gastroenterology 2013, 144, e9–e10. [Google Scholar] [CrossRef] [Scilit]
  130. Broadbent, K.; Lovegrove, M. Not just another sore throat. Aust. Fam. Physician 2011, 40, 605–606. [Google Scholar]
  131. Santini, M.; Fiorello, A.; Cappabianca, S.; Vicidomini, G. Unusual case of Boerhaave syndrome, diagnosed late and successfully treated by Abbott’s T-tube. J. Thorac. Cardiovasc. Surg. 2007, 134, 539–540. [Google Scholar] [CrossRef] [Scilit]
  132. Yagnik, V.D.; Yagnik, B.D. An unusual cause of left-sided severe chest pain. Saudi J. Gastroenterol. 2011, 17, 82–83. [Google Scholar] [CrossRef] [Scilit]
  133. White, S. Another case of chest pain on the acute medical take! BMJ Case Rep. 2012, 2012, bcr2012006539. [Google Scholar] [CrossRef] [Scilit]
  134. Adam, A.; Watkinson, A.F.; Dussek, J. Boerhaave syndrome: To treat or not to treat by means of insertion of a metallic stent. J. Vasc. Interv. Radiol. 1995, 6, 741–743. [Google Scholar] [CrossRef] [Scilit]
  135. Tanaka, R.; Kosugi, S.; Sato, D.; Hirukawa, H.; Tada, T.; Ichikawa, H.; Hanyu, T.; Ishikawa, T.; Kobayashi, T.; Wakai, T. Conservative treatment of esophageal perforation related to a peptic ulcer with pyloric stenosis. Clin. J. Gastroenterol. 2014, 7, 295–298. [Google Scholar] [CrossRef] [Scilit]
  136. Ota, K.; Takeuchi, T.; Higuchi, K. Temporary insertion of a covered self-expandable metal stent for spontaneous esophageal rupture. Dig. Endosc. 2014, 26, 607–608. [Google Scholar] [CrossRef] [Scilit]
  137. Rokszin, R.; Simonka, Z.; Paszt, A.; Szepes, A.; Kucsa, K.; Lazar, G. Successful endoscopic clipping in the early treatment of spontaneous esophageal perforation. Surg. Laparosc. Endosc. Percutan. Tech. 2011, 21, e311–e312. [Google Scholar] [CrossRef] [Scilit]
  138. Schneider, S.M.; Goodman, D. Spontaneous rupture of the esophagus presenting with unilateral proptosis. Ann. Emerg. Med. 1984, 13, 374–377. [Google Scholar] [CrossRef] [Scilit]
  139. Anderson, R.E.; Wilcox, S.; Miller, E.S. A Rare but Lethal Cause of Chest Pain. J. Emerg. Med. 2015, 49, 698–702. [Google Scholar] [CrossRef] [Scilit]
  140. Ruttan, T.K.; Sanders, A.B. “Paramedics are bringing in a hypotensive gastrointestinal bleeder”: An unexpected diagnosis. J. Emerg. Med. 2012, 43, e227–e229. [Google Scholar] [CrossRef] [Scilit]
  141. Scharl, M.; Stanek, N.; Kröger, A.; Bauerfeind, P.; Gubler, C. Successful treatment of a proximal esophageal rupture with a luminal sponge. Endoscopy 2015, 47, E293–E294. [Google Scholar] [CrossRef] [Scilit]
  142. Klein, P.E.; Kapoor, T. Female with abdominal pain and neck swelling. J. Emerg. Med. 2012, 43, 344–345. [Google Scholar] [CrossRef] [Scilit]
  143. Ali, N.; Abate, G. Candida Empyema as a Red Flag for Esophageal Rupture: A Case Report and Literature Review. Case Rep. Infect. Dis. 2020, 2020, 3935691. [Google Scholar] [CrossRef] [Scilit]
  144. McLean, M.M.; Tilney, P.V. Esophageal rupture in a 25-year-old man. Air Med. J. 2012, 31, 199–202. [Google Scholar] [CrossRef] [Scilit]
  145. Reeder, L.B.; Warren, S.E.; Ferguson, M.K. Recurrent spontaneous perforation of the esophagus. Ann. Thorac. Surg. 1995, 59, 221–222. [Google Scholar] [CrossRef] [Scilit]
  146. Lujan, H.J.; Lin, P.H.; Boghossian, S.P.; Yario, R.F.; Tatooles, C.J. Recurrent spontaneous rupture of the esophagus: An unusual late complication of Boerhaave’s syndrome. Surgery 1997, 122, 634–636. [Google Scholar] [CrossRef] [Scilit]
  147. Khan, O.A.; Barlow, C.W.; Weeden, D.F.; Amer, K.M. Recurrent spontaneous esophageal rupture. Eur. J. Cardiothorac. Surg. 2005, 28, 178–179. [Google Scholar] [CrossRef] [Scilit]
  148. Ieta, K.; Oki, A.; Teshigahara, K.; Osone, K.; Sasaki, S.; Nakamura, J.; Nakagawa, K.; Kuwano, H. Recurrent spontaneous esophageal rupture. Clin. J. Gastroenterol. 2013, 6, 33–37. [Google Scholar] [CrossRef] [Scilit]
  149. Maurya, V.K.; Sharma, P.; Ravikumar, R.; Bhatia, M. Boerhaave’s syndrome. Med. J. Armed Forces India 2016, 72, S105–S107. [Google Scholar] [CrossRef] [Scilit]
  150. Ashok, K.; Mahalakshmi, A.; Hariesh, A.; Kalyanaraman, A. Anaesthetic and haemodynamic management of Boerhaave’s syndrome. Indian J. Anaesth. 2017, 61, 182–183. [Google Scholar] [CrossRef] [Scilit]
  151. Catarino Santos, S.; Barbosa, B.; Sá, M.; Constantino, J.; Casimiro, C. Boerhaave’s syndrome: A case report of damage control approach. Int. J. Surg. Case Rep. 2019, 58, 104–107. [Google Scholar] [CrossRef] [Scilit]
  152. Valdivielso Cortázar, E.; Couto Wörner, I.; Alonso Aguirre, P. Endoscopic management of Boerhaave’s syndrome. Rev. Esp. Enferm. Dig. 2019, 111, 493. [Google Scholar] [CrossRef] [Scilit]
  153. Janjua, K.J. Boerhaave’s syndrome. Postgrad. Med. J. 1997, 73, 265–270. [Google Scholar] [CrossRef] [Scilit]
  154. Saito, S.; Hosoya, Y.; Kurashina, K.; Matsumoto, S.; Kanamaru, R.; Ui, T.; Haruta, H.; Kitayama, J.; Lefor, A.K.; Sata, N. Boerhaave’s syndrome in a patient with an upside down stomach: A case report. Int. J. Surg. Case Rep. 2016, 19, 51–54. [Google Scholar] [CrossRef] [Scilit]
  155. Ashrafi, A.S.; Horkoff, M.J.; Mohammad, W.M.; Tadros, S.; Sundaresan, S. Boerhaave’s syndrome secondary to an incarcerated inguinal hernia: A case report. Int. J. Surg. Case Rep. 2016, 28, 234–236. [Google Scholar] [CrossRef] [Scilit]
  156. Singh, G.S.; Slovis, C.M. “Occult” Boerhaave’s syndrome. J. Emerg. Med. 1988, 6, 13–16. [Google Scholar] [CrossRef] [Scilit]
  157. Smith, J.S.; McCallister, J.W. Boerhaave’s Syndrome. West. J. Emerg. Med. 2010, 11, 74–75. [Google Scholar]
  158. Bhargava, J.; Tiwari, R.L.; Jain, S. Anesthetic management in spontaneous esophageal rupture (Boerhaave’s syndrome). J. Anaesthesiol. Clin. Pharmacol. 2016, 32, 126–127. [Google Scholar] [CrossRef] [Scilit]
  159. Nguyen Ho, L.; Tran Van, N.; Le, T.V. Boerhaave’s syndrome—Tension hydropneumothorax and rapidly developing hydropneumothorax: Two radiographic clues in one case. Respirol. Case Rep. 2016, 4, e00160. [Google Scholar] [CrossRef] [Scilit]
  160. Hill, A.G.; Tiu, A.T.; Martin, I.G. Boerhaave’s syndrome: 10 years experience and review of the literature. ANZ J. Surg. 2003, 73, 1008–1010. [Google Scholar] [CrossRef] [Scilit]
  161. Jagminas, L.; Silverman, R.A. Boerhaave’s syndrome presenting with abdominal pain and right hydropneumothorax. Am. J. Emerg. Med. 1996, 14, 53–56. [Google Scholar] [CrossRef] [Scilit]
  162. Craven, G.G.; Whittaker, M.G. Boerhaave’s syndrome as a complication of pre-existent gastrointestinal disease. Ir. J. Med. Sci. 1992, 161, 670–674. [Google Scholar] [CrossRef] [Scilit]
  163. Reardon, E.S.; Martin, L.W. Boerhaave’s syndrome presenting as a mid-esophageal perforation associated with a right-sided pleural effusion. J. Surg. Case Rep. 2015, 2015, rjv142. [Google Scholar] [CrossRef] [Scilit]
  164. Kuwano, H.; Yokobori, T.; Kumakura, Y.; Ogata, K.; Yoshida, T.; Kuriyama, K.; Sakai, M.; Sohda, M.; Miyazaki, T.; Saeki, H.; et al. Pathophysiology of Vomiting and Esophageal Perforation in Boerhaave’s Syndrome. Dig. Dis. Sci. 2020, 65, 3253–3259. [Google Scholar] [CrossRef] [Scilit]
  165. Tanaka, H.; Uemura, N.; Nishikawa, D.; Oguri, K.; Abe, T.; Higaki, E.; Hosoi, T.; An, B.; Hasegawa, Y.; Shimizu, Y. Boerhaave syndrome due to hypopharyngeal stenosis associated with chemoradiotherapy for hypopharyngeal cancer: A case report. Surg. Case Rep. 2018, 4, 54. [Google Scholar] [CrossRef] [Scilit]
  166. Ould-Nana, I.; Szabo, M.; Farghadani, H.; Leyder, E.; Bodlet, A. Boerhaave’s syndrome initially presented with sore throat and cough complicated by a bilateral pneumothorax. Acta Gastroenterol. Belg. 2020, 83, 322–324. [Google Scholar]
  167. Spapen, J.; De Regt, J.; Nieboer, K.; Verfaillie, G.; Honoré, P.M.; Spapen, H. Boerhaave’s Syndrome: Still a Diagnostic and Therapeutic Challenge in the 21st Century. Case Rep. Crit. Care. 2013, 2013, 161286. [Google Scholar] [CrossRef] [Scilit]
  168. Sohoni, C.A. Remarkable computed tomography findings in Boerhaave’s syndrome. Lung India 2014, 31, 304–305. [Google Scholar] [CrossRef] [Scilit]
  169. Adhikari, D.R.; Tiwari, A.R.; Vankipuram, S.; Chaphekar, A.P.; Satardey, R. A Successful Strategy for Surgical Treatment of Boerhaave’s Syndrome Sans Thoracotomy. J. Clin. Diagn. Res. 2015, 9, PD05–PD06. [Google Scholar] [CrossRef] [Scilit]
  170. Truyens, M.; Hufkens, E.; Van Geluwe, B.; Vergauwe, P.; Van Moerkercke, W. Boerhaave’s syndrome: Successful conservative treatment in two patients. Acta Gastroenterol. Belg. 2020, 83, 654–656. [Google Scholar]
  171. van der Weg, G.; Wikkeling, M.; van Leeuwen, M.; TerAvest, E. A rare case of oesophageal rupture: Boerhaave’s syndrome. Int. J. Emerg. Med. 2014, 7, 27. [Google Scholar] [CrossRef] [Scilit]
  172. Grobmyer, S.R.; Naama, H.; Behfarin, P.; Engstad, K.; Ko, W. Boerhaave’s syndrome. J. Am. Coll. Surg. 2001, 192, 232. [Google Scholar] [CrossRef] [Scilit]
  173. Yu, J.Y.; Kim, S.K.; Jang, E.C.; Yeom, J.O.; Kim, S.Y.; Cho, Y.S. Boerhaave’s syndrome during bowel preparation with polyethylene glycol in a patient with postpolypectomy bleeding. World J. Gastrointest. Endosc. 2013, 5, 270–272. [Google Scholar] [CrossRef] [Scilit]
  174. Nakano, T.; Sato, C.; Sakurai, T.; Kamiya, K.; Kamei, T.; Ohuchi, N. Thoracoscopic esophageal repair with barbed suture material in a case of Boerhaave’s syndrome. J. Thorac. Dis. 2016, 8, E1576–E1580. [Google Scholar] [CrossRef] [Scilit]
  175. Toelen, C.; Hendrickx, L.; Van Hee, R. Laparoscopic treatment of Boerhaave’s syndrome: A case report and review of the literature. Acta Chir. Belg. 2007, 107, 402–404. [Google Scholar] [CrossRef] [Scilit]
  176. Alkhuja, S.; Gazizov, N.; Charles, G. Pneumomediastinum Complicating Diabetic Ketoacidosis and Boerhaave’s Syndrome. Case Rep. Med. 2013, 2013, 598720. [Google Scholar] [CrossRef] [Scilit]
  177. Chung, M.G.; Kang, D.H.; Park, D.K.; Park, J.J.; Park, H.C.; Kim, J.H. Successful treatment of Boerhaave’s syndrome with endoscopic insertion of a self-expandable metallic stent: Report of three cases and a review of the literature. Endoscopy 2001, 33, 894–897. [Google Scholar] [CrossRef] [Scilit]
  178. Rassameehiran, S.; Klomjit, S.; Nugent, K. Right-sided hydropneumothorax as a presenting symptom of Boerhaave’s syndrome (spontaneous esophageal rupture). Bayl. Univ. Med. Cent. Proc. 2015, 28, 344–346. [Google Scholar] [CrossRef] [Scilit]
  179. Venø, S.; Eckardt, J. Boerhaave’s syndrome and tension pneumothorax secondary to Norovirus induced forceful emesis. J. Thorac. Dis. 2013, 5, E38–E40. [Google Scholar] [CrossRef] [Scilit]
  180. Jackson, W.E.; Mehendiratta, V.; Palazzo, J.; Dimarino, A.J.; Quirk, D.M.; Cohen, S. Boerhaave’s syndrome as an initial presentation of eosinophilic esophagitis: A case series. Ann. Gastroenterol. 2013, 26, 166–169. [Google Scholar]
  181. Haba, Y.; Yano, S.; Akizuki, H.; Hashimoto, T.; Naito, T.; Hashiguchi, N. Boerhaave syndrome due to excessive alcohol consumption: Two case reports. Int. J. Emerg. Med. 2020, 13, 56. [Google Scholar] [CrossRef] [Scilit]
  182. Veltri, A.; Weindelmayer, J.; Alberti, L.; De Pasqual, C.A.; Bencivenga, M.; Giacopuzzi, S. Laparoscopic transhiatal suture and gastric valve as a safe and feasible treatment for Boerhaave’s syndrome: An Italian single center case series study. World J. Emerg. Surg. 2020, 15, 42. [Google Scholar] [CrossRef] [Scilit]
  183. Curci, J.J.; Horman, M.J. Boerhaave’s syndrome: The importance of early diagnosis and treatment. Ann. Surg. 1976, 183, 401–408. [Google Scholar] [CrossRef] [Scilit]
  184. Malik, U.F.; Young, R.; Pham, H.D.; McCon, A.; Shen, B.; Landres, R.; Mahmoud, A. Chronic presentation of Boerhaave’s syndrome. BMC Gastroenterol. 2010, 10, 29. [Google Scholar] [CrossRef] [Scilit]
  185. Lewis, A.M.; Dharmarajah, R. Walked in with Boerhaave’s…. Emerg. Med. J. 2007, 24, e24. [Google Scholar] [CrossRef] [Scilit]
  186. Jougon, J.; Mc Bride, T.; Delcambre, F.; Minniti, A.; Velly, J.F. Primary esophageal repair for Boerhaave’s syndrome whatever the free interval between perforation and treatment. Eur. J. Cardiothorac. Surg. 2004, 25, 475–479. [Google Scholar] [CrossRef] [Scilit]
  187. Hingston, C.D.; Saayman, A.G.; Frost, P.J.; Wise, M.P. Boerhaave’s syndrome—Rapidly evolving pleural effusion; a radiographic clue. Minerva Anestesiol. 2010, 76, 865–867. [Google Scholar]
  188. Craik, J.D.; Laffer, C.H.; Newton, A. Boerhaave’s syndrome: A pain in the neck. Emerg. Med. J. 2009, 26, 461–462. [Google Scholar] [CrossRef] [Scilit]
  189. Ayeni, J.P.; Macfie, J. Spontaneous rupture of the oesophagus (Boerhaave’s syndrome). J. R. Soc. Med. 1990, 83, 60–61. [Google Scholar] [CrossRef] [Scilit]
  190. Onyeka, W.O.; Booth, S.J. Boerhaave’s syndrome presenting as tension pneumothorax. J. Accid. Emerg. Med. 1999, 16, 235–236. [Google Scholar] [CrossRef] [Scilit]
  191. Kollmar, O.; Lindemann, W.; Richter, S.; Steffen, I.; Pistorius, G.; Schilling, M.K. Boerhaave’s syndrome: Primary repair vs. esophageal resection—Case reports and meta-analysis of the literature. J. Gastrointest. Surg. 2003, 7, 726–734. [Google Scholar] [CrossRef] [Scilit]
  192. Corns, R.A.; Edwards, J.L. Boerhaave’s syndrome: CT diagnosis. Ann. R. Coll. Surg. Engl. 2004, 86, W8–W9. [Google Scholar] [CrossRef] [Scilit]
  193. Darrien, J.H.; Kasem, H. Minimally invasive endoscopic therapy for the management of Boerhaave’s syndrome. Ann. R. Coll. Surg. Engl. 2013, 95, 552–556. [Google Scholar] [CrossRef] [Scilit]
  194. Spinoglio, G.; Summa, M.; Quarati, R.; Testa, S.; Priora, F.; Lenti, M.L.; Ravazzoni, F.; Piscioneri, D. Thoracoscopic and Laparoscopic Esophagectomy in a Case of Spontaneous Rupture of the Esophagus (Boerhaave’s Syndrome). Eur. J. Trauma Emerg. Surg. 2009, 35, 414–416. [Google Scholar] [CrossRef] [Scilit]
  195. Ghatak, T.; Singh, R.K.; Samanta, S. Hemodynamically unstable atrial fibrillation after oral contrast dye instillation in a case of Boerhaave’s syndrome. Saudi J. Anaesth. 2013, 7, 479–480. [Google Scholar] [CrossRef] [Scilit]
  196. Ashrafi, A.S.; Awais, O.; Alvelo-Rivera, M. Minimally invasive management of Boerhaave’s syndrome. Ann. Thorac. Surg. 2007, 83, 317–319. [Google Scholar] [CrossRef] [Scilit]
  197. McVay, C.B. Treatment of a case of combined Mallory-Weiss and Boerhaave’s syndrome. Surg. Clin. N. Am. 1970, 50, 1111–1117. [Google Scholar] [CrossRef] [Scilit]
  198. Schwartz, J.A.; Turnbull, T.L.; Dymowski, J.; Uehara, D.T. Boerhaave’s syndrome: An elusive diagnosis. Am. J. Emerg. Med. 1986, 4, 532–536. [Google Scholar] [CrossRef] [Scilit]
  199. Spronk, P.E.; Beishuizen, A.; van der Hoven, B. Belching and the development of Boerhaave’s syndrome. Intensive Care Med. 2001, 27, 330. [Google Scholar] [CrossRef] [Scilit]
  200. Patel, M.S.; Chakraborty, P.U. A case of Boerhaave’s syndrome presenting after a trial of non-invasive ventilation. Med. Princ. Prac. 2009, 18, 155–158. [Google Scholar] [CrossRef] [Scilit]
  201. Prichard, R.; Butt, J.; Al-Sariff, N.; Frohlich, S.; Murphy, S.; Manning, B.; Ravi, N.; Reynolds, J.V. Management of spontaneous rupture of the oesophagus (Boerhaave’s syndrome): Single centre experience of 18 cases. Ir. J. Med. Sci. 2006, 175, 66–70. [Google Scholar] [CrossRef] [Scilit]
  202. Atallah, F.N.; Riu, B.M.; Nguyen, L.B.; Seguin, P.O.; Fourcade, O.A. Boerhaave’s syndrome after postoperative vomiting. Anesth. Analg. 2004, 98, 1164–1166. [Google Scholar] [CrossRef] [Scilit]
  203. Bailey, C.; Burke, S. Boerhaave’s syndrome complicating status epilepticus. Br. J. Hosp. Med. 2010, 71, 53. [Google Scholar] [CrossRef] [Scilit]
  204. Joyce, M.; Ryan, T.; Falke, L.M. Management of Boerhaave’s syndrome in a regional setting. Ir. J. Med. Sci. 2001, 170, 77. [Google Scholar] [CrossRef] [Scilit]
  205. Landen, S.; El Nakadi, I. Minimally invasive approach to Boerhaave’s syndrome: A pilot study of three cases. Surg. Endosc. 2002, 16, 1354–1357. [Google Scholar] [CrossRef] [Scilit]
  206. Drury, M.; Anderson, W.; Heffner, J.E. Diagnostic value of pleural fluid cytology in occult Boerhaave’s syndrome. Chest 1992, 102, 976–978. [Google Scholar] [CrossRef] [Scilit]
  207. Babic, T.; Banfic, L.; Papa, J.; Barisic, N.; Jelincic, Z.; Zurak, N. Spontaneous rupture of oesophagus (Boerhaave’s syndrome) related to rivastigmine. Age Ageing 2000, 29, 370–371. [Google Scholar] [CrossRef] [Scilit]
  208. Zenone, E.A.; Trotman, B.W. Boerhaave’s syndrome. Spontaneous formation of an esophageal-bronchial fistula. JAMA 1977, 238, 2048–2049. [Google Scholar] [CrossRef] [Scilit]
  209. Matsushita, M.; Sakai, S.; Matsusue, S.; Takeda, H.; Huang, C.L.; Hajiro, K.; Okazaki, K. Open chest drainage for postoperative empyema in Boerhaave’s syndrome. Dig. Dis. Sci. 1998, 43, 1518–1520. [Google Scholar] [CrossRef] [Scilit]
  210. Curtis, D.L.; Burbige, E.J.; Milligan, F.D. Boerhaave’s syndrome: Role of esophagoscopy. Gastrointest. Endosc. 1976, 22, 208–209. [Google Scholar] [CrossRef] [Scilit]
  211. Witz, M.; Jedeikin, R.; Zager, M.; Shpitz, B.; Elyashiv, A.; Dinbar, A. Spontaneous rupture of distal oesophagus (Boerhaave’s syndrome) with unusual clinical presentation of pneumoperitoneum. Postgrad. Med. J. 1984, 60, 60–61. [Google Scholar] [CrossRef] [Scilit]
  212. Troum, S.; Lane, C.E.; Dalton, M.L., Jr. Surviving Boerhaave’s syndrome without thoracotomy. Chest 1994, 106, 297–299. [Google Scholar] [CrossRef] [Scilit]
  213. Mikami, R.; Nakamoto, Y.; Ikeda, H.; Kayata, H.; Murakami, T.; Yamamoto, M. Primary closure of a spontaneous esophageal rupture under hand-assisted laparoscopy: A case report. Surg. Case Rep. 2016, 2, 70. [Google Scholar] [CrossRef] [Scilit]
  214. Jenkins, I.R.; Raymond, R. Boerhaave’s syndrome complicated by a large bronchopleural fistula. Chest 1994, 105, 964–965. [Google Scholar] [CrossRef] [Scilit]
  215. Sabanathan, S.; Eng, J.; Pradhan, G.N. Boerhaave’s syndrome complicating acute myocardial infarction. Case report. Scand. J. Thorac. Cardiovasc. Surg. 1990, 24, 87–88. [Google Scholar] [CrossRef] [Scilit]
  216. Sekiya, S.; Ebihara, Y.; Yamamura, Y.; Tanaka, K.; Nakanishi, Y.; Asano, T.; Noji, T.; Kurashima, Y.; Murakami, S.; Nakamura, T.; et al. Two emergency cases of spontaneous esophageal perforation treated using a minimally invasive abdominal and left thoracic approach. Asian J. Endosc. Surg. 2020, 13, 406–409. [Google Scholar] [CrossRef] [Scilit]
  217. Tsalis, K.; Vasiliadis, K.; Tsachalis, T.; Christoforidis, E.; Blouhos, K.; Betsis, D. Management of Boerhaave’s syndrome: Report of three cases. J. Gastrointest. Liver Dis. 2008, 17, 81–85. [Google Scholar]
  218. Hutzelmann, A.; Wesner, F.; Freund, M.; Heller, M. Quiz case of the month. Boerhaave’s Syndr. Eur. Radiol. 1997, 7, 293–294. [Google Scholar] [CrossRef] [Scilit]
  219. Türüt, H.; Gulhan, E.; Adams, P.Y.; Cetin, G. Successful conservative management of Boerhaave’s syndrome with late presentation. J. Natl. Med. Assoc. 2006, 98, 1857–1859. [Google Scholar]
  220. Maglinte, D.D.; Edwards, M.C. Spontaneous closure of esophageal tear in Boerhaave’s syndrome. Gastrointest. Radiol. 1979, 4, 223–225. [Google Scholar] [CrossRef] [Scilit]
  221. Kyriacou, D.N. A case of Boerhaave’s syndrome presenting as diffuse left pulmonary infiltrate. Ann. Emerg. Med. 1991, 20, 1239–1242. [Google Scholar] [CrossRef] [Scilit]
  222. Hashmi, M.A.R.; El-Badawy, M.; Agha, A. Suspecting a fatal condition on a plain chest radiograph; Boerhaave syndrome. Scott. Med. J. 2021, 66, 46–48. [Google Scholar] [CrossRef] [Scilit]
  223. Foroulis, C.N.; Desimonas, N. Delayed rupture of a primary esophageal repair for Boerhaave’s syndrome. Eur. J. Cardiothorac. Surg. 2004, 26, 870. [Google Scholar] [CrossRef] [Scilit]
  224. Nabili, S.; Murdoch, J.R. A case of Boerhaave’s syndrome associated with raised intraocular pressure. Br. J. Ophthalmol. 2003, 87, 650–651. [Google Scholar] [CrossRef] [Scilit]
  225. Davies, A.P.; Vaughan, R. Expanding mesh stent in the emergency treatment of Boerhaave’s syndrome. Ann. Thorac. Surg. 1999, 67, 1482–1483. [Google Scholar] [CrossRef] [Scilit]
  226. Munemura, T.; Suzuki, O.; Ootake, S.; Manase, H.; Fujimori, M.; Kato, H. A rare case of spontaneous esophageal rupture (Boerhaave’s syndrome) associated with pulmonary rupture. Jpn. J. Thorac. Cardiovasc. Surg. 1998, 46, 1074–1077. [Google Scholar] [CrossRef] [Scilit]
  227. Harries, K.; Masoud, A.; Brown, T.H.; Richards, D.G. Endoscopic placement of fibrin sealant as a treatment for a long-standing Boerhaave’s fistula. Dis. Esophagus 2004, 17, 348–350. [Google Scholar] [CrossRef] [Scilit]
  228. Kallis, P.; Belsham, P.A.; Pepper, J.R. Spontaneous rupture of the oesophagus (Boerhaave’s syndrome): Conservative versus surgical management. J. R. Soc. Med. 1991, 84, 690–691. [Google Scholar] [CrossRef] [Scilit]
  229. Harikrishnan, S.; Murugesan, C.S.; Karthikeyan, R.; Manickavasagam, K.; Singh, B. Challenges faced in the management of complicated Boerhaave syndrome: A tertiary care center experience. Pan Afr. Med. J. 2020, 36, 65. [Google Scholar]
  230. Wei, L.; Wang, F.; Chen, S. A late diagnosed case of Spontaneous esophageal perforation in an elderly patient. Int. J. Clin. Exp. Med. 2015, 8, 11594–11597. [Google Scholar]
  231. Levy, F.; Mysko, W.K.; Kelen, G.D. Spontaneous esophageal perforation presenting with right-sided pleural effusion. J. Emerg. Med. 1995, 13, 321–325. [Google Scholar] [CrossRef] [Scilit]
  232. Glenny, R.W.; Fulkerson, W.J.; Ravin, C.E. Occult spontaneous esophageal perforation. Unusual clinical and radiographic presentation. Chest 1987, 92, 562–565. [Google Scholar] [CrossRef] [Scilit]
  233. Attia, R.; Rohatgi, A.; Scarci, M.; Hamouda, A.; Botha, A.J. Boerhaave’s syndrome secondary to colonic interposition graft perforation. Int. J. Colorectal Dis. 2010, 25, 1147–1148. [Google Scholar] [CrossRef] [Scilit]
  234. Loske, G.; Schorsch, T.; Müller, C. Endoscopic intracavitary vacuum therapy of Boerhaave’s syndrome: A case report. Endoscopy 2010, 42, E144–E145. [Google Scholar] [CrossRef] [Scilit]
  235. Trueman, D. A case study: Boerhaave’s syndrome. Air Med. J. 2004, 23, 30–32. [Google Scholar] [CrossRef] [Scilit]
  236. Gopalan, R.; Cooke, C.G. Images in clinical medicine. Boerhaave’s syndrome. N. Engl. J. Med. 2000, 343, 190. [Google Scholar] [CrossRef] [Scilit]
  237. Smyth, A.R.; Wastell, C. Spontaneous rupture of the oesophagus (Boerhaave’s syndrome): Delayed diagnosis and successful conservative management. J. R. Soc. Med. 1989, 82, 498. [Google Scholar] [CrossRef] [Scilit]
  238. Achem, S.R. Boerhaave’s syndrome. Dig. Dis. 2000, 18, 106. [Google Scholar] [CrossRef] [Scilit]
  239. Chan-Tack, K.M. Boerhaave’s syndrome. Lancet 2002, 359, 823. [Google Scholar] [CrossRef] [Scilit]
  240. Weil, R.J. Candidal mediastinitis after surgical repair of esophageal perforation. South. Med. J. 1991, 84, 1052–1053. [Google Scholar] [CrossRef] [Scilit]
  241. Klausner, J.M.; Epstein, L.; Peer, G.; Lelcuck, S.; Skornick, Y.; Rozin, R.R. Perforation of the esophagus (Boerhaave’s syndrome) during hemodialysis. Nephron 1985, 40, 372–373. [Google Scholar] [CrossRef] [Scilit]
  242. Dominguez, A.; Garcia, M.J.; Rayo, M.; Duque, A.; Marrero, F. Boerhaave’s syndrome complicating acute myocardial infarction thrombolysis. Intensive Care Med. 2001, 27, 1682. [Google Scholar] [CrossRef] [Scilit]
  243. Mota, H.J.; Ximenes Netto, M.; Medeiros Ada, C. Postemetic rupture of the esophagus: Boerhaave’s syndrome. J. Bras. Pneumol. 2007, 33, 480–483, (In English, Portuguese). [Google Scholar] [CrossRef] [Scilit]
  244. Ho, L.N.; Van, H.L. Boerhaave’s syndrome: Food particles in chest tube. Pan Afr. Med. J. 2017, 27, 100. [Google Scholar] [CrossRef] [Scilit]
  245. Baird, J.; Norinsky, A.B. When gastroenteritis isn’t: A case report of a 20-year-old male with Boerhaave’s syndrome complicated by intra-abdomimal hemorrhage. World J. Emerg. Med. 2016, 7, 303–306. [Google Scholar] [CrossRef] [Scilit]
  246. Achem, S.R. Boerhaave’s syndrome. Dig. Dis. 1999, 17, 256, Correction in J. Parasitol. 1975, 61, 970–972. [Google Scholar] [CrossRef] [Scilit]
  247. Lee, T.C.; Liu, K.L.; Wang, H.P. Images of interest. Gastrointestinal: Boerhaave’s syndrome. J. Gastroenterol. Hepatol. 2005, 20, 1788. [Google Scholar] [CrossRef] [Scilit]
  248. Petruzziello, L.; Tringali, A.; Riccioni, M.E.; Mutignani, M.; Margaritora, S.; Cesario, A.; Costamagna, G. Successful early treatment of Boerhaave’s syndrome by endoscopic placement of a temporary self-expandable plastic stent without fluoroscopy. Gastrointest. Endosc. 2003, 58, 608–612. [Google Scholar] [CrossRef] [Scilit]
  249. Franceschi, F.; Lesi, C.; Monti, C.; Lemma, E. Boerhaave’s syndrome: Description of a case with endoscopic confirmation. Endoscopy 1978, 10, 297–301. [Google Scholar] [CrossRef] [Scilit]
  250. Bolooki, H.; Anderson, I.; Garcia-Rivera, C.; Jude, J.R. Spontaneous rupture of the esophagus: Boerhaave’s syndrome. Ann. Surg. 1971, 174, 319–324. [Google Scholar] [CrossRef] [Scilit]
  251. Kochar, T.; Dhingra, P.S.; Khaliq, M.F.; Mcjunkin, B. Eosinophilic esophagitis presenting with spontaneous esophageal rupture: A case report. J. Med. Case Rep. 2019, 13, 275. [Google Scholar] [CrossRef] [Scilit]
  252. Rochford, M.; Kiernan, T.J. Images in emergency medicine. Ann. Emerg. Med. 2007, 49, 746, 777. [Google Scholar] [CrossRef] [Scilit]
  253. Ampollini, L.; Bobbio, A.; Carbognani, P.; Rusca, M. Successful esophageal repair in patient with Boerhaave’s syndrome. Eur. J. Cardiothorac. Surg. 2006, 30, 555. [Google Scholar] [CrossRef] [Scilit]
  254. Cohen, M.S.; Kaufman, A.; DiMarino, A.J., Jr.; Cohen, S. Eosinophilic esophagitis presenting as spontaneous esophageal rupture (Boerhaave’s syndrome). Clin. Gastroenterol. Hepatol. 2007, 5, A24. [Google Scholar] [CrossRef] [Scilit]
  255. Ribeiro, T.A.; Cordoval, L.T.D.C.; Viana Neto, E.M.; Ribeiro, M.A.; Motta, E.G.P.C. Boerhaave’s syndrome: A differential diagnosis of chest and abdominal pain. Radiol. Bras. 2018, 51, 124–125. [Google Scholar] [CrossRef] [Scilit]
  256. Eubanks, P.J.; Hu, E.; Nguyen, D.; Procaccino, F.; Eysselein, V.E.; Klein, S.R. Case of Boerhaave’s syndrome successfully treated with a self-expandable metallic stent. Gastrointest. Endosc. 1999, 49, 780–783. [Google Scholar] [CrossRef] [Scilit]
  257. Scott, H.J.; Rosin, R.D. Thoracoscopic repair of a transmural rupture of the oesophagus (Boerhaave’s syndrome). J. R. Soc. Med. 1995, 88, 414P–415P. [Google Scholar]
  258. Aloreidi, K.; Patel, B.; Ridgway, T.; Yeager, T.; Atiq, M. Non-surgical management of Boerhaave’s syndrome: A case series study and review of the literature. Endosc. Int. Open 2018, 6, E92–E97. [Google Scholar] [CrossRef] [Scilit]
  259. Dumonceau, J.M.; Devière, J.; Cappello, M.; Van Gossum, A.; Cremer, M. Endoscopic treatment of Boerhaave’s syndrome. Gastrointest. Endosc. 1996, 44, 477–479. [Google Scholar] [CrossRef] [Scilit]
  260. Liu, L.; Wu, W.; Gong, L.; Zhang, M. Contralateral spontaneous rupture of the esophagus following severe emesis after non-intubated pulmonary wedge resection. J. Cardiothorac. Surg. 2020, 15, 285. [Google Scholar] [CrossRef] [Scilit]
  261. Mwamure, P.; Pasupati, S.; Swarbrick, M.; Lin, R.; Fisher, R. Dual life-threatening pathologies presenting simultaneously. BMJ Case Rep. 2009, 2009, bcr0120091491. [Google Scholar] [CrossRef] [Scilit]
  262. Dieckhaus, K.D.; Hill, D.R. Boerhaave’s syndrome due to herpes simplex virus type 1 esophagitis in a patient with AIDS. Clin. Infect. Dis. 1998, 26, 1244–1245. [Google Scholar] [CrossRef] [Scilit]
  263. Nehra, D.; Beynon, J.; Pye, J.K. Spontaneous rupture of the oesophagus (Boerhaave’s syndrome). Postgrad. Med. J. 1993, 69, 214–216. [Google Scholar] [CrossRef] [Scilit]
  264. D’Journo, X.B.; Doddoli, C.; Avaro, J.P.; Lienne, P.; Giovannini, M.A.; Giudicelli, R.; Fuentes, P.A.; Thomas, P.A. Long-term observation and functional state of the esophagus after primary repair of spontaneous esophageal rupture. Ann. Thorac. Surg. 2006, 81, 1858–1862. [Google Scholar] [CrossRef] [Scilit]
  265. Gubbins, G.P.; Nensey, Y.M.; Schubert, T.T.; Batra, S.K. Barogenic perforation of the esophagus distal to a stricture after endoscopy. J. Clin. Gastroenterol. 1990, 12, 310–312. [Google Scholar] [CrossRef] [Scilit]
  266. Teh, E.; Edwards, J.; Duffy, J.; Beggs, D. Boerhaave’s syndrome: A review of management and outcome. Interact. Cardiovasc. Thorac. Surg. 2007, 6, 640–643. [Google Scholar] [CrossRef] [Scilit]
  267. Vyas, D. Conservative management of a three-day-old esophageal perforation with feeding jejunostomy and prokinetic drug. Scand. J. Gastroenterol. 2006, 41, 1242–1244. [Google Scholar] [CrossRef] [Scilit]
  268. Reddy, S.; Butt, M.W.; Samra, G.S. A potentially fatal complication of postoperative vomiting: Boerhaave’s syndrome. Eur. J. Anaesthesiol. 2008, 25, 257–259. [Google Scholar] [CrossRef] [Scilit]
  269. Reñé, M.; Valls, C.; Hidalgo, F.; Prieto, L. Duodenal gallstone ileus producing Boerhaave’s syndrome. Abdom. Imaging 1995, 20, 516–517. [Google Scholar] [CrossRef] [Scilit]
  270. Tariq, T.; Rizvi, A.; Badwal, K.; Eke, R. Spontaneous Intramural Esophageal Rupture: An Uncommon Presentation of Eosinophilic Esophagitis Requiring Endoscopic Clipping. ACG Case Rep. J. 2018, 5, e66. [Google Scholar] [CrossRef] [Scilit]
  271. Razi, E.; Davoodabadi, A.; Razi, A. Spontaneous esophageal perforation presenting as a right-sided pleural effusion: A case report. Tanaffos 2013, 12, 53–57. [Google Scholar]
  272. Baric, A. Oesophageal rupture in a patient with postoperative nausea and vomiting. Anaesth. Intensive Care 2000, 28, 325–327. [Google Scholar] [CrossRef] [Scilit]
  273. Uehara, D.T.; Dymowski, J.J.; Schwartz, J.; Turnbull, T.L. Chest pain, shock, and pneumomediastinum in a previously healthy 56-year-old man. Ann. Emerg. Med. 1987, 16, 359–364. [Google Scholar] [CrossRef] [Scilit]
  274. Modi, B.P.; Owens, C.; Ashley, S.W.; Colson, Y.L. Bouveret meets Boerhaave. Ann. Thorac. Surg. 2006, 81, 1493–1495. [Google Scholar] [CrossRef] [Scilit]
  275. Jurani, C.C.; Early, G.L.; Roberts, S.R. Spontaneous esophageal perforation presenting as meningitis. Ann. Thorac. Surg. 2002, 73, 1294–1296. [Google Scholar] [CrossRef] [Scilit]
  276. de Belder, M.A.; Walker, J.D.; Burnie, J.P.; Rothman, M.T. Survival after rupture of the oesophagus and subsequent candidal endocarditis: Use of new serological methods in management. Eur. Heart J. 1989, 10, 858–862. [Google Scholar] [CrossRef] [Scilit]
  277. Fiscon, V.; Portale, G.; Frigo, F.; Migliorini, G.; Fania, P.L. Spontaneous rupture of middle thoracic esophagus: Thoracoscopic treatment. Surg. Endosc. 2010, 24, 2900–2902. [Google Scholar] [CrossRef] [Scilit]
  278. LoCicero, J., 3rd; Vanecko, R.M. Clostridial myonecrosis of the chest wall complicating spontaneous esophageal rupture. Ann. Thorac. Surg. 1985, 40, 396–397. [Google Scholar] [CrossRef] [Scilit]
  279. Bak, Y.T.; Kwon, O.S.; Yeon, J.E.; Kim, J.S.; Byun, K.S.; Kim, J.H.; Kim, J.G.; Lee, C.H.; Choi, Y.H.; Kang, D.H. Endoscopic treatment in a case with extensive spontaneous intramural dissection of the oesophagus. Eur. J. Gastroenterol. Hepatol. 1998, 10, 969–972. [Google Scholar] [CrossRef] [Scilit]
  280. Fiscon, V.; Portale, G.; Fania, P.; Duodeci, S.; Frigo, F.; Migliorini, G. Successful minimally invasive repair of spontaneous esophageal perforation. J. Laparoendosc. Adv. Surg. Tech. A 2008, 18, 721–722. [Google Scholar] [CrossRef] [Scilit]
  281. Mittal, S.; Rohatgi, A.; Sutcliffe, R.P.; Botha, A. Spontaneous perforation of cervical oesophagus: A rare variant of Boerhaave’s syndrome. J. Laryngol. Otol. 2009, 123, 1378–1380. [Google Scholar] [CrossRef] [Scilit]
  282. Walker, W.S.; Cameron, E.W.; Walbaum, P.R. Diagnosis and management of spontaneous transmural rupture of the oesophagus (Boerhaave’s syndrome). Br. J. Surg. 1985, 72, 204–207. [Google Scholar] [CrossRef] [Scilit]
  283. Vernon, N.; Mohananey, D.; Ghetmiri, E.; Ghaffari, G. Esophageal rupture as a primary manifestation in eosinophilic esophagitis. Case Rep. Med. 2014, 2014, 673189. [Google Scholar] [CrossRef] [Scilit]
  284. Saha, A.; Jarvis, M.; Thorpe, J.A.; O’Regan, D.J. Atypical presentation of Boerhaave’s syndrome as Enterococcal bacterial pericardial effusion. Interact. Cardiovasc. Thorac. Surg. 2007, 6, 130–132. [Google Scholar] [CrossRef] [Scilit]
  285. Sabanathan, S.; Eng, J.; Richardson, J. Surgical management of intrathoracic oesophageal rupture. Br. J. Surg. 1994, 81, 863–865. [Google Scholar] [CrossRef] [Scilit]
  286. Otsuka, K.; Murakami, M.; Ariyoshi, T.; Yamashita, T.; Goto, S.; Watanabe, M.; Aoki, T. Endoscopic clipping of spontaneous esophageal rupture: Case reports of three patients. Int. J. Surg. Case Rep. 2017, 38, 18–22. [Google Scholar] [CrossRef] [Scilit]
  287. Sakamoto, Y.; Tanaka, N.; Furuya, T.; Ueno, T.; Okamoto, H.; Nagai, M.; Murakawa, T.; Takayama, T.; Mafune, K.; Makuuchi, M.; et al. Surgical management of late esophageal perforation. Thorac. Cardiovasc. Surg. 1997, 45, 269–272. [Google Scholar] [CrossRef] [Scilit]
  288. Mahmodlou, R.; Abdirad, I.; Ghasemi-Rad, M. Aggressive surgical treatment in late-diagnosed esophageal perforation: A report of 11 cases. ISRN Surg. 2011, 2011, 868356. [Google Scholar] [CrossRef] [Scilit]
  289. Shinozuka, E.; Nomura, T.; Miyashita, M.; Makino, H.; Okawa, K.; Hagiwara, N.; Shigehara, K.; Akagi, I.; Shioda, Y.; Uchida, E. Successful treatment of a spontaneous esophageal rupture in an elderly patient: A case report. J. Nippon. Med. Sch. 2010, 77, 338–341. [Google Scholar] [CrossRef] [Scilit]
  290. Ochiai, T.; Hiranuma, S.; Takiguchi, N.; Ito, K.; Maruyama, M.; Nagahama, T.; Kawano, T.; Nagai, K.; Nishikage, T.; Noguchi, N.; et al. Treatment strategy for Boerhaave’s syndrome. Dis. Esophagus 2004, 17, 98–103. [Google Scholar] [CrossRef] [Scilit]
  291. Kuwabara, J.; Watanabe, Y.; Kojima, Y.; Higaki, N.; Ikeda, Y.; Sato, K.; Yoshida, M.; Yamamoto, Y.; Kikuchi, S. Successful closure of spontaneous esophageal rupture (Boerhaave’s syndrome) by endoscopic ligation with snare loops. Springerplus 2016, 5, 921. [Google Scholar] [CrossRef] [Scilit]
  292. Aga, Z.; Avelino, J.; Darling, G.E.; Leung, J.J. An Unusual Case of Spontaneous Esophageal Rupture after Swallowing a Boneless Chicken Nugget. Case Rep. Emerg. Med. 2016, 2016, 5971656. [Google Scholar] [CrossRef] [Scilit]
  293. Berrisford, R.G.; Krishnadas, R.; Froeschle, P.O.; Wajed, S. Transgastric drainage of the oesophagus: Managing difficult oesophageal injuries. Eur. J. Cardiothorac. Surg. 2008, 33, 742–744. [Google Scholar] [CrossRef] [Scilit]
  294. Kircheva, D.Y.; Vigneswaran, W.T. Successful primary repair of late diagnosed spontaneous esophageal rupture: A case report. Int. J. Surg. Case Rep. 2017, 35, 49–52. [Google Scholar] [CrossRef] [Scilit]
  295. Ohri, S.K.; Liakakos, T.A.; Pathi, V.; Townsend, E.R.; Fountain, S.W. Primary repair of iatrogenic thoracic esophageal perforation and Boerhaave’s syndrome. Ann. Thorac. Surg. 1993, 55, 603–606. [Google Scholar] [CrossRef] [Scilit]
  296. Petousis, S.; Margioula-Siarkou, C.; Lorenzi, B.; Charalabopoulos, A.; Sdralis, E.K. High mortality rate of oesophageal perforation is associated with delayed hospital admission: A prospective observational case series study. Acta Gastroenterol. Belg. 2020, 83, 11–14. [Google Scholar]
  297. Griffiths, E.A.; Yap, N.; Poulter, J.; Hendrickse, M.T.; Khurshid, M. Thirty-four cases of esophageal perforation: The experience of a district general hospital in the UK. Dis. Esophagus 2009, 22, 616–625. [Google Scholar] [CrossRef] [Scilit]
  298. Hayakawa, S.; Mitsui, A.; Kato, Y.; Morimoto, S.; Watanabe, K.; Shamoto, T.; Wakasugi, T.; Kuwabara, Y. Laparoscopic transhiatal suture closure for spontaneous esophageal rupture: A case report. Surg. Case Rep. 2019, 5, 149. [Google Scholar] [CrossRef] [Scilit]
  299. Leoncini, G.; Novello, L.; Denegri, A.; Morelli, L.; Ratto, G.B. Successful primary staple-repair of thoracic oesophagus after delayed presentation of a spontaneous perforation. Int. J. Surg. Case Rep. 2015, 14, 167–171. [Google Scholar] [CrossRef] [Scilit]
  300. Moriarity, A.R.; Larkin, J.O.; O’Sullivan, K.E.; Ravi, N.; Reynolds, J.V. Spontaneous perforation of the esophagus in a patient with achalasia. Ann. Thorac. Surg. 2013, 96, 1456–1457. [Google Scholar] [CrossRef] [Scilit]
  301. Eroğlu, A.; Kürkçüoğlu, C.; Karaoğlanoğlu, N.; Tekinbaş, C.; Cesur, M. Spontaneous esophageal rupture following severe vomiting in pregnancy. Dis. Esophagus 2002, 15, 242–243. [Google Scholar] [CrossRef] [Scilit]
  302. Rustagi, T.; Majumder, S. Dysphagia and spontaneous esophageal perforation in sarcoidosis. Dig. Dis. Sci. 2013, 58, 282–285. [Google Scholar] [CrossRef] [Scilit]
  303. Altorjay, A.; Szilágyi, A.; Sárkány, A.; Varga, I.; Jachymczyk, G.; Paál, B.; Kecskés, G. Synchronous spontaneous perforation of the esophagus and a duodenal ulcer. Dis. Esophagus 2005, 18, 207–210. [Google Scholar] [CrossRef] [Scilit]
  304. Haws, M.J.; Kucan, J.O.; Zamboni, W.A.; Hussmann, J. Spontaneous esophageal perforation in an acute burn patient. Ann. Plast. Surg. 1996, 37, 641–644. [Google Scholar] [CrossRef] [Scilit]
  305. Helton, W.B.; Unnikrishnan, R.; Gal, T. Cervical esophageal perforation and cricopharyngeal dysfunction. Ear Nose Throat J. 2011, 90, E8–E10. [Google Scholar] [CrossRef] [Scilit]
  306. Altorjay, A.; Kiss, J.; Vörös, A.; Szirányi, E. The role of esophagectomy in the management of esophageal perforations. Ann. Thorac. Surg. 1998, 65, 1433–1436. [Google Scholar] [CrossRef] [Scilit]
  307. Nakashima, S.; Shiozaki, A.; Fujiwara, H.; Murayama, Y.; Komatsu, S.; Ikoma, H.; Kuriu, Y.; Nakanishi, M.; Ichikawa, D.; Okamoto, K.; et al. Spontaneous rupture of the esophagus with extensive bowel necrosis caused by nonocclusive mesenteric ischemia: Report of a case. Surg. Today 2012, 42, 1107–1110. [Google Scholar] [CrossRef] [Scilit]
  308. Larsson, H.; Attwood, S. Eosinophilic esophagitis (EoE); a disease that must not be neglected—Implications of esophageal rupture and its management. BMC Gastroenterol. 2020, 20, 185. [Google Scholar] [CrossRef] [Scilit]
  309. Salminen, P.; Gullichsen, R.; Laine, S. Use of self-expandable metal stents for the treatment of esophageal perforations and anastomotic leaks. Surg. Endosc. 2009, 23, 1526–1530. [Google Scholar] [CrossRef] [Scilit]
  310. Gock, M.; Schäfer, M.; Perren, A.; Demartines, N.; Clavien, P.A. Fatal esophageal perforation caused by invasive candidiasis. Ann. Thorac. Surg. 2005, 80, 1120–1122. [Google Scholar] [CrossRef] [Scilit]
  311. Hochberg, L.A.; Parlamis, N. Spontaneous perforation and rupture of the esophagus with a report of five cases. Am. J. Surg. 1961, 102, 428–438. [Google Scholar] [CrossRef] [Scilit]
  312. Wilde, P.H.; Mullany, C.J. Oesophageal perforation—A review of 37 cases. Aust. N. Z. J. Surg. 1987, 57, 743–747. [Google Scholar] [CrossRef] [Scilit]
  313. Larsson, S.; Pettersson, G.; Lepore, V. Esophagocutaneous drainage to treat late and complicated esophageal perforation. Eur. J. Cardiothorac. Surg. 1991, 5, 579–582. [Google Scholar] [CrossRef] [Scilit]
  314. Dye, R.A.; Laforet, E.G. Esophageal rupture: Diagnosis by pleural fluid pH. Chest 1974, 66, 454–456. [Google Scholar] [CrossRef] [Scilit]
  315. Bresadola, V.; Terrosu, G.; Favero, A.; Cattin, F.; Cherchi, V.; Adani, G.L.; Marcellino, M.G.; Bresadola, F.; De Anna, D. Treatment of perforation in the healthy esophagus: Analysis of 12 cases. Langenbecks Arch. Surg. 2008, 393, 135–140. [Google Scholar] [CrossRef] [Scilit]
  316. Morimoto, Y.; Mukai, T. Spontaneous esophageal rupture treated by conservative therapy. Jpn. J. Thorac. Cardiovasc. Surg. 2000, 48, 473–475. [Google Scholar] [CrossRef] [Scilit]
  317. Mizutani, K.; Makuuchi, H.; Tajima, T.; Mitomi, T. The diagnosis and treatment of esophageal perforations resulting from nonmalignant causes. Surg. Today 1997, 27, 793–800. [Google Scholar] [CrossRef] [Scilit]
  318. Clark, D.H.; Tankel, H.I. Pressure rupture and spontaneous perforation of the oesophagus. Gut 1964, 5, 86–89. [Google Scholar] [CrossRef] [Scilit]
  319. Ghandour, Z.; al Karawi, M.A.; Mohamed, A.E. Spontaneous esophageal perforation: Unusual presentation of tuberculosis. Endoscopy 1997, 29, 143–144. [Google Scholar] [CrossRef] [Scilit]
  320. Cascio, A.; Barone, M.; Micali, V.; Iaria, C.; Delfino, D.; David, A.; Monaco, M.; Monaco, F. On a fatal case of Candida krusei pleural empyema in a pregnant woman with spontaneous esophagus perforation. Mycopathologia 2010, 169, 451–455. [Google Scholar] [CrossRef] [Scilit]
  321. Sidhu, S.; Curran, S.; Robinson, G. Spontaneous oesophageal perforation with simultaneous perforated duodenal ulcer. Aust. N. Z. J. Surg. 1998, 68, 374–375. [Google Scholar] [CrossRef] [Scilit]
  322. Toghill, P.J.; MacGuire, C.F.; Raut, P.S. “Spontaneous” rupture of the healthy oesophagus. Postgrad. Med. J. 1968, 44, 504–508. [Google Scholar] [CrossRef] [Scilit]
  323. Wilson, R.F.; Sarver, E.J.; Arbulu, A.; Sukhnandan, R. Spontaneous perforation of the esophagus. Ann. Thorac. Surg. 1971, 12, 291–296. [Google Scholar] [CrossRef] [Scilit]
  324. Harrington, J.D. Spontaneous rupture of the oesophagus. Australas. Radiol. 1972, 16, 123–125. [Google Scholar] [CrossRef] [Scilit]
  325. Drinkwater, J.B. Spontaneous rupture of the oesophagus. Proc. R. Soc. Med. 1969, 62, 644–645. [Google Scholar] [CrossRef] [Scilit]
  326. Chen, T.C.; Wu, M.H.; Cheng, Y.J.; Chang, P.C. Spontaneous pharyngoesophageal perforations. Eur. J. Cardiothorac. Surg. 2011, 40, 1250–1252. [Google Scholar] [CrossRef] [Scilit]
  327. Cochrane, P. Spontaneous oesophageal rupture after carbachol therapy. Br. Med. J. 1973, 1, 463–464. [Google Scholar] [CrossRef] [Scilit]
  328. Klygis, L.M.; Jutabha, R.; McCrohan, M.B.; Vanagunas, A.D. Esophageal perforations masked by steroids. Abdom. Imaging 1993, 18, 10–12. [Google Scholar] [CrossRef] [Scilit]
  329. Bradham, R.R.; de Saussure, C.; Lemel, A.L. Spontaneous perforation of the cervical esophagus. Arch. Surg. 1976, 111, 284–285. [Google Scholar] [CrossRef] [Scilit]
  330. Hamilton, S.G. Spontaneous rupture of the oesophagus. Br. J. Surg. 1967, 54, 304–306. [Google Scholar] [CrossRef] [Scilit]
  331. Limburg, A.J.; Hesselink, E.J.; Kleibeuker, J.H. Barrett’s ulcer: Cause of spontaneous oesophageal perforation. Gut 1989, 30, 404–405. [Google Scholar] [CrossRef] [Scilit]
  332. Mayer, J.E., Jr.; Murray, C.A.; Varco, R.L. The treatment of esophageal perforation with delayed recognition and continuing sepsis. Ann. Thorac. Surg. 1977, 23, 568–573. [Google Scholar] [CrossRef] [Scilit]
  333. O’Connell, N.D. Spontaneous rupture of the esophagus. Proc. R. Soc. Med. 1965, 58, 857–859. [Google Scholar] [CrossRef] [Scilit]
  334. Pandey, C.K.; Bose, N.; Dash, N.R.; Singh, N.; Saxena, R. Perioperative management of a patient presenting with a spontaneously ruptured esophagus. Can. J. Anaesth. 2002, 49, 409–412. [Google Scholar] [CrossRef] [Scilit]
  335. Härmä, R.A.; Koskinen, Y.O.; Suurkari, S.O. Spontaneous rupture of the oesophagus: Endoscopic treatment in the primary stage. Thorax 1968, 23, 210–213. [Google Scholar] [CrossRef] [Scilit]
  336. Millard, A.H. ‘Spontaneous’ perforation of the oesophagus treated by utilization of a pericardial flap. Br. J. Surg. 1971, 58, 70–72. [Google Scholar] [CrossRef] [Scilit]
  337. Katz, S.J.; Lieberman, A.; Hechtman, H.B. Spontaneous perforation of the esophagus associated with smooth muscle hypertrophy. Am. J. Surg. 1974, 127, 338–341. [Google Scholar] [CrossRef] [Scilit]
  338. McKeown, D.R.; Dejode, L.R. Spontaneous Rupture of the Oesophagus with Recovery Following Repair. Proc. R. Soc. Med. 1965, 58, 431–432. [Google Scholar] [CrossRef] [Scilit]
  339. Phillipps, J.J. Spontaneous perforation of the cervical oesophagus. J. Laryngol. Otol. 1988, 102, 69–70. [Google Scholar] [CrossRef] [Scilit]
  340. Sanderson, R.G. Spontaneous Rupture of the Esophagus; Report of Survival without Surgical Management. Am. J. Surg. 1965, 109, 506–508. [Google Scholar] [CrossRef] [Scilit]
  341. Chung, C.H. Spontaneous oesophageal perforation as a complication of vomiting in gastroenteritis—Case report. Eur. J. Emerg. Med. 2004, 11, 231–233. [Google Scholar] [CrossRef] [Scilit]
  342. Andersen, O.S.; Giustra, P.E. Nonoperative management of contained esophageal perforation. Arch. Surg. 1981, 116, 1214–1217. [Google Scholar] [CrossRef] [Scilit]
  343. Matsumoto, M.A.; Rockoff, S.D.; Aaron, B.L. Tension pyopneumothorax. Rare presentation of ruptured Barrett’s esophagus. Chest 1993, 103, 1604–1606. [Google Scholar] [CrossRef] [Scilit]
  344. Asplund, C.M.; Hill, L.D. Delayed lower esophageal perforation: Management with Celestin tube. Ann. Otol. Rhinol. Laryngol. 1985, 94, 114–116. [Google Scholar] [CrossRef] [Scilit]
  345. Becker, G.D. Posterior nasal packing, spontaneous perforation of the esophagus and gram negative septicemia: Report of a case. Laryngoscope 1973, 83, 1828–1833. [Google Scholar] [CrossRef] [Scilit]
  346. Hutter, J.A.; Fenn, A.; Braimbridge, M.V. The management of spontaneous oesophageal perforation by thoracoscopy and irrigation. Br. J. Surg. 1985, 72, 208–209. [Google Scholar] [CrossRef] [Scilit]
  347. Westaby, S. An improved method for primary repair after spontaneous oesophageal perforation. Br. J. Surg. 1980, 67, 801–803. [Google Scholar] [CrossRef] [Scilit]
  348. Kaplan, L.M.; Compton, C.C. Case records of the Massachusetts General Hospital. Weekly Clinicopathological exercises. Case 4-1989. Sudden onset of abdominal pain and hematemesis in a 56-year-old woman. N. Engl. J. Med. 1989, 320, 235–244. [Google Scholar] [CrossRef] [Scilit]
  349. Ando, H.; Shitara, Y.; Hagiwara, K.; Hara, K.; Mogami, Y.; Kobayashi, T.; Yajima, T.; Tani, M.; Morinaga, N.; Ishizaki, M.; et al. Successful surgical treatment of a spontaneous rupture of the esophagus diagnosed two days after onset. Case Rep. Gastroenterol. 2012, 6, 260–265. [Google Scholar] [CrossRef] [Scilit]
  350. Symbas, P.N.; Hatcher, C.R., Jr.; Harlaftis, N. Spontaneous rupture of the esophagus. Ann. Surg. 1978, 187, 634–640. [Google Scholar] [CrossRef] [Scilit]
  351. Shaligram, A.; Dugar, N.; Capper, R. Perforation of cervical oesophagus. J. Laryngol. Otol. 2005, 119, 51–53. [Google Scholar] [CrossRef] [Scilit]
  352. McGovern, M.; Egerton, M.J. Spontaneous perforation of the cervical oesophagus. Med. J. Aust. 1991, 154, 277–278. [Google Scholar] [CrossRef] [Scilit]
  353. Ikeda, Y.; Niimi, M.; Sasaki, Y.; Shatari, T.; Takami, H.; Kodaira, S. Thoracoscopic repair of a spontaneous perforation of the esophagus with the endoscopic suturing device. J. Thorac. Cardiovasc. Surg. 2001, 121, 178–179. [Google Scholar] [CrossRef] [Scilit]
  354. Agrawal, V.; Aggarwal, D. Undiagnosed spontaneous oesophageal rupture presenting as right hydropneumothorax. Indian J. Thorac. Cardiovasc. Surg. 2019, 35, 111–114. [Google Scholar] [CrossRef] [Scilit]
  355. Liang, H.; Li, X.; Wei, Z. Elevated tumour markers in the pleural effusion of a patient with spontaneous esophageal rupture: A rare case report. J. Cardiothorac. Surg. 2025, 20, 301. [Google Scholar] [CrossRef] [Scilit]
  356. Ersin, O.E.; Yanık, F.; Karamustafaoğlu, Y.A.; Yörük, Y. Mediastinitis secondary to esophageal rupture; A case of Boerhaave syndrome. SAGE Open Med. Case Rep. 2025, 13, 2050313X251357371. [Google Scholar] [CrossRef] [Scilit]
  357. Pei, B.; Gu, W.; Guan, Q.; Kong, B. Surgical treatment experiences in two cases of spontaneous esophageal ruptures. J. Surg. Case Rep. 2025, 2025, rjaf406. [Google Scholar] [CrossRef] [Scilit]
  358. Magalhães, E.; Fonte Martins, M.; Fertusinhos, M.; Palma Rios, H.; Luís, D. Endoscopic Closure of a Spontaneous Esophageal Perforation Using an Over-the-Scope Clip (OTSC®): A Conservative Approach to Boerhaave Syndrome. Cureus 2025, 17, e83442. [Google Scholar] [CrossRef] [Scilit]
  359. Soares, C.; Araújo, R.; Cancela, E.; Castanheira, A. Tulip-bundle technique for suture dehiscence in a Boerhaave syndrome. Rev. Esp. Enferm. Dig. 2025, 117, 283–284. [Google Scholar] [CrossRef] [Scilit]
  360. Xiong, S.Y.; Liu, C.J.; Li, Y.F.; Zhang, H.L.; Chen, X.W.; Wang, H.M.; Chen, J.C. Multimodal diagnostic and surgical approach to spontaneous esophageal rupture induced by severe coughing: A case report. World J. Gastrointest. Surg. 2025, 17, 101578. [Google Scholar] [CrossRef] [Scilit]
  361. Calderón-Cabrera, D.C.; Cobián-Cerna, E.J.; Zanabria-Caya, C. Boerhaave syndrome: A case report of successful conservative treatment. Rev. Gastroenterol. Mex. 2025, 90, 318–319. [Google Scholar] [CrossRef] [Scilit]
  362. Gharingam, M.L.; Vanrossomme, A.E. Boerhaave Syndrome: A Case Report. J. Belg. Soc. Radiol. 2025, 109, 11. [Google Scholar] [CrossRef] [Scilit]
  363. Bakhshi, G.; Tiwari, S.; Dutt, A.; Menon, B.; Ochiramani, B. A Rare but Lethal Emergency: A Case Report on Boerhaave’s Syndrome. Cureus 2025, 17, e80377. [Google Scholar] [CrossRef] [Scilit]
  364. Hussey, T.; Banh, S.; Kastora, S.L.; Vakharia, H. Painless esophageal rupture in the second stage of labor presenting as surgical emphysema of the neck: A case report. J. Med. Case Rep. 2025, 19, 49. [Google Scholar] [CrossRef] [Scilit]
  365. Chenevas-Paule, Q.; Sage, P.Y.; Chirica, M. Management of Boerhaave syndrome by right thoracoscopy in prone position (with video). J. Visc. Surg. 2025, 162, 61–64. [Google Scholar] [CrossRef] [Scilit]
  366. Ishimine, D.; Sunagawa, H.; Teruya, M.; Hayashi, K. Laparoscopic Intra-Mediastinum Omental Filling Repair for Spontaneous Esophageal Rupture: A Case Report. Surg. Case Rep. 2025, 11, cr24-0131. [Google Scholar] [CrossRef] [Scilit]
  367. Mendes, I.; Nunes, G.; Vara-Luiz, F.; Vaz, J.; Luz, C.; Fonseca, J.; Pinto-Marques, P. Endoscopic vacuum therapy of a refractory esophagopleural fistula in a patient with Boerhaave syndrome, using an innovative hybrid stent. Endoscopy 2024, 56, E683–E684. [Google Scholar] [CrossRef] [Scilit]
  368. Han, M.; Xia, X.; Mitsos, S.; Lin, J.; Stuart, C.M.; Yu, L. Esophageal perforation mimicking an acute inferior myocardial infarction: A case report. J. Thorac. Dis. 2024, 16, 8117–8125. [Google Scholar] [CrossRef] [Scilit]
  369. Tzioti, M.K.; Marinou, A.; Sidiropoulos, T.; Karachaliou, A.; Danias, N. Nonoperative Management of Boerhaave Syndrome: A Case Study. Cureus 2024, 16, e72573. [Google Scholar] [CrossRef] [Scilit]
  370. Kuthadi, M.; Surendar Reddy, K.; Mood, N.; Papayagari, A.; Gattu, R. Milk in the intercostal tube: Revealing Boerhaave syndrome. Respirol. Case Rep. 2024, 12, e70056. [Google Scholar] [CrossRef] [Scilit]
  371. Soussi, D.; Alharahsheh, B.H.A.; Boshier, P.R.; Hoare, J.; Direkze, N.; Thomas, R.; Peters, C.J.; Stevens, S. Endoluminal Vacuum Therapy for the Management of Boerhaave Syndrome: A Case Series. Case Rep. Gastroenterol. 2024, 18, 402–411. [Google Scholar] [CrossRef] [Scilit]
  372. Schalet, R.; Carro Cruz, F.; Berezowski, I.; Adams-Mardi, C.; Haile, H.; Schueler, S.A.; Borum, M.L. Boerhaave Syndrome Mimicking Acute Coronary Syndrome. ACG Case Rep. J. 2024, 11, e01453. [Google Scholar] [CrossRef] [Scilit]
  373. Morgom, M.; Saeed, L.; Ali, H.; Elhassan, H. The Hidden Tear: Improving Diagnostic Accuracy for Spontaneous Esophageal Perforation in the ED. Cureus 2024, 16, e65482. [Google Scholar] [CrossRef] [Scilit]
  374. Eremia, I.A.; Anghel, C.A.; Cofaru, F.A.; Nica, S. Early Presentation of Boerhaave Syndrome in the Emergency Department: A Case Report and Review of the Literature. Diagnostics 2024, 14, 1592. [Google Scholar] [CrossRef] [Scilit]
  375. Mangeshkar, S.; Borkowski, P.; Shokrekhuda, A.; Barillas-Lara, M.I.; Menegus, M.A. Boerhaave syndrome: An unusual myocardial infarction mimic-a case report. Eur. Heart J. Case Rep. 2024, 8, ytae310. [Google Scholar] [CrossRef] [Scilit]
  376. Ribeiro, R.; Cardoso, P.; Santos, F. A Conservative and Multidisciplinary Approach to Boerhaave Syndrome: A Case Report. Cureus 2024, 16, e59602. [Google Scholar] [CrossRef] [Scilit]
  377. Tipton, K.N.; Schroder, D. A Critical Combination of Esophageal Rupture and Upside-down Stomach: A Case Report. Clin. Prac. Cases Emerg. Med. 2024, 8, 95–98. [Google Scholar] [CrossRef] [Scilit]
  378. Bhojani, F.; Shafqat, G.; Zafar, U.; Khan, A. Bubbles and esophagus: A tale of unexpected and otherwise unexplained pain. Radiol. Case Rep. 2024, 19, 2043–2047. [Google Scholar] [CrossRef] [Scilit]
  379. Aldoseri, R.; Nasser, M.; Alshehabi, M. A Case of an Atypical Presentation of Spontaneous Esophageal Rupture. Cureus 2024, 16, e57578. [Google Scholar] [CrossRef] [Scilit]
  380. Qureshi, A.; Mansuri, U.; Roknsharifi, M.; Ghobrial, Y.; Asgeri, A.; Asgeri, M. Endoscopic Management of Boerhaave Syndrome: Are Outcomes Better Than Surgery? A Case Report and Review of Literature. J. Community Hosp. Intern. Med. Perspect. 2024, 14, 104–108. [Google Scholar] [CrossRef] [Scilit]
  381. Nakano, Y.; Nakamura, T.; Tomatsu, M.; Miyaki, Y.; Suzuki, K. Mediastinal hematoma as an unusual intrathoracic manifestation of Boerhaave Syndrome: A case report. Int. J. Surg. Case Rep. 2024, 116, 109366. [Google Scholar] [CrossRef] [Scilit]
  382. Mahant, S.S.; Lanjewar, A. A Case Report of Conservatively Managed Boerhaave Syndrome. Cureus 2024, 16, e55225. [Google Scholar] [CrossRef] [Scilit]
  383. Redan, J.A.; Croteau, T.; Gaughan, C. Boerhaave’s Syndrome Presenting in the Setting of Third-Degree Heart Block. CRSLS 2024, 11, e2023.00052. [Google Scholar] [CrossRef] [Scilit]
  384. Swied, M.Y.; Alom, M.; Daaboul, O.; Azzawi, M.; Swied, A. Esophageal Perforation Presenting Initially as Multiple Brain Abscesses Secondary to Streptococcus intermedius. J. Investig. Med. High Impact Case Rep. 2024, 12, 23247096241239572. [Google Scholar] [CrossRef] [Scilit]
  385. Ravikumar, D.B.; Sivasubramanian, B.P.; Dominic Savio, F.V.; Gunendran, T.; Shekar, S.P. A Green Surprise: Bilateral Bilious Pleural Effusion Secondary to Esophageal Rupture-A Case Report. J. Investig. Med. High. Impact Case Rep. 2024, 12, 23247096241231634. [Google Scholar] [CrossRef] [Scilit]
  386. Ito, S.; Ogawa, R.; Komura, M.; Hayakawa, S.; Okubo, T.; Sagawa, H.; Tanaka, T.; Mitsui, A.; Takahashi, S.; Takiguchi, S. Severe esophageal stricture after perforation and necrotizing esophagitis: Unusual presentation of a duodenal gastrinoma. J. Surg. Case Rep. 2023, 2023, rjad679. [Google Scholar] [CrossRef] [Scilit]
  387. Estorninho, J.; Pimentel, R.; Gravito-Soares, M.; Gravito-Soares, E.; Amaro, P.; Figueiredo, P. Successful Endoscopic Closure of Esophageal Perforation in Boerhaave Syndrome Using the Over-the-Scope Clip. GE Port. J. Gastroenterol. 2022, 30, 444–450. [Google Scholar] [CrossRef] [Scilit]
  388. Kwiatkowska, N.M.; Kaminska, A.; Sielewicz, M.; Kasprzyk, M.; Piwkowski, C. Boerhaave syndrome complicated by subsequent esophageal stenosis and esophageal fistula. Kardiochir. Torakochir. Pol. 2023, 20, 274–276. [Google Scholar] [CrossRef] [Scilit]
  389. Totsi, A.; Fortounis, K.; Michailidou, S.; Balasas, N.; Papavasiliou, C. Early Diagnosis and Surgical Management of Boerhaave Syndrome: A Case Report. Cureus 2023, 15, e47596. [Google Scholar] [CrossRef] [Scilit]
  390. Zhang, J.; Yang, X.; Jiang, H.; Liu, J.; Wang, J.; Zhu, H. Spontaneous oesophageal perforation secondary to renal colic. Oxf. Med. Case Rep. 2023, 2023, omad112. [Google Scholar] [CrossRef] [Scilit]
  391. Huynh, N.; Easwaralingam, N.; Khan, M.; Suppiah, A. Atypical presentation of Boerhaave’s syndrome in a remote Australian setting. BMJ Case Rep. 2023, 16, e253964. [Google Scholar] [CrossRef] [Scilit]
  392. Piratheepan, A.; Inthujan, S.; Sutharshan, V. Successful retrosternal esophageal bypass with gastric transposition in the management of esophago-pleural fistula as a complication of Boerhaave syndrome. Int. J. Surg. Case Rep. 2023, 111, 108797. [Google Scholar] [CrossRef] [Scilit]
  393. Parapar Álvarez, L.; Cerrella Cano, C.; Vargas González, C.A.; Armesto González, E.M. Endoscopic endoluminal therapy with the Eso-SPONGE® system for the treatment of spontaneous esophageal perforation with associated paraoesophageal collection. Rev. Esp. Enferm. Dig. 2023, 115, 589. [Google Scholar] [CrossRef] [Scilit]
  394. Canelas Mendes, C.; Duarte, L.; Madeira Lopes, J. Boerhaave’s Syndrome: An Unusual Geriatric Presentation. Cureus 2023, 15, e46212. [Google Scholar] [CrossRef] [Scilit]
  395. Shaik, M.R.; Shaik, N.A.; Kunarathnam, V.; Bilgrami, Z.; Wheeler, E.; Hu, S. Esophageal Perforation Unveiling the Diagnosis of Zollinger-Ellison Syndrome. J. Community Hosp. Intern. Med. Perspect. 2023, 13, 77–81. [Google Scholar] [CrossRef] [Scilit]
  396. Tarazona, M.A.D.; Chaves, C.E.R.; Mateus, J.F.I.; Comba, F.A.R.; Rosso, J.D.; Uribe, M.C.A. Boerhaave syndrome: Successful conservative treatment. Case report and literature review. Int. J. Surg. Case Rep. 2023, 107, 108289. [Google Scholar] [CrossRef] [Scilit]
  397. Jáquez-Quintana, J.O.; Scharrer-Cabello, S.; Baeza-Zapata, A.A.; Maldonado-Garza, H.J.; Sánchez-Otero, M.J.; Téllez-Hinojosa, C.A. Endoscopic stent placement after spontaneous esophageal perforation associated with chemoradiotherapy for esophageal cancer. Rev. Esp. Enferm. Dig. 2023, 115, 327–328. [Google Scholar] [CrossRef] [Scilit]
  398. Samidoust, P.; Ashoobi, M.T.; Aghajanzadeh, M.; Delshad, M.S.E.; Haghighi, M. Boerhaave’s syndrome in a patient with achalasia: A rare case report. Int. J. Surg. Case Rep. 2023, 106, 108183. [Google Scholar] [CrossRef] [Scilit]
  399. Loftus, I.A.; Umana, E.E.; Scholtz, I.P.; McElwee, D. Mackler’s Triad: An Evolving Case of Boerhaave Syndrome in the Emergency Department. Cureus 2023, 15, e37978. [Google Scholar] [CrossRef] [Scilit]
  400. Darlington, C.R.; Copertino, N. Boerhaave syndrome following the use of Kambo from the Amazonian Phyllomedusa bicolor tree frog in Australia. Oxf. Med. Case Rep. 2023, 2023, omad036. [Google Scholar] [CrossRef] [Scilit]
  401. Pattynama, L.M.D.; Eshuis, W.J.; Wielenga, M.C.B.; Pouw, R.E. Successful endoscopic management of a large esophageal defect due to Boerhaave syndrome with endoscopic vacuum therapy using vacuum sponge and vacuum stent. VideoGIE 2023, 8, 144–147. [Google Scholar] [CrossRef] [Scilit]
  402. Khadka, B.; Khanal, K.; Dahal, P.; Adhikari, H. A rare case of Boerhaave syndrome with cervico-thoracic esophageal junction rupture causing bilateral empyema; case report from Nepal. Int. J. Surg. Case Rep. 2023, 105, 108018. [Google Scholar] [CrossRef] [Scilit]
  403. Oh, S.; Lee, Y.K.; Hong, Y.J.; Ahn, Y.; Jeong, M.H. Boerhaave syndrome initially presenting as acute coronary syndrome with systolic total obstruction of myocardial bridge. Korean J. Intern. Med. 2023, 38, 271–272. [Google Scholar] [CrossRef] [Scilit]
  404. Ariza-Traslaviña, J.; Caballero-Otálora, N.; Polanía-Sandoval, C.A.; Perez-Rivera, C.J.; Tellez, L.J.; Mosquera, M. Two-staged surgical management for complicated Boerhaave syndrome with esophagectomy and deferred gastroplasty: A case report. Int. J. Surg. Case Rep. 2023, 103, 107881. [Google Scholar] [CrossRef] [Scilit]
  405. Tanaka, T.; Ikeuchi, R.; Hisamatsu, K.; Mizuno, D.; Koyanagi, T.; Morihiro, T.; Kurosaki, T.; Uno, F.; Wada, S.; Tanaka, H.; et al. Boerhaave syndrome presenting black pleural effusion: A case report. Respir. Med. Case Rep. 2022, 40, 101781. [Google Scholar] [CrossRef] [Scilit]
  406. Maki, H.; Inoue, S.; Goto, M.; Nishino, T.; Yoshida, T.; Takizawa, H. Spontaneous esophageal perforation within a hiatal hernia: A case report. Int. J. Surg. Case Rep. 2022, 98, 107484. [Google Scholar] [CrossRef] [Scilit]
  407. Bury, J.; Fratczak, A.; Nielson, J.A. Atypical Presentation of Boerhaave Syndrome With Hypoxia and Unresponsiveness. Cureus 2022, 14, e27848. [Google Scholar] [CrossRef] [Scilit]
  408. Nachiappan, M.; Thota, R.; Gadiyaram, S. Laparoscopic Repair of Spontaneous Esophageal Perforation After Multiple Endoscopic Failures. Cureus 2022, 14, e26784. [Google Scholar] [CrossRef] [Scilit]
  409. Burnett, T.B.; Fischer, N.J. In quick succession: Boerhaave’s following hepatectomy. ANZ J. Surg. 2022, 92, 1911–1913. [Google Scholar] [CrossRef] [Scilit]
  410. Tan, N.; Luo, Y.H.; Li, G.C.; Chen, Y.L.; Tan, W.; Xiang, Y.H.; Ge, L.; Yao, D.; Zhang, M.H. Presentation of Boerhaave’s syndrome as an upper-esophageal perforation associated with a right-sided pleural effusion: A case report. World J. Clin. Cases 2022, 10, 6192–6197. [Google Scholar] [CrossRef] [Scilit]
  411. Kita, R.; Kobayashi, H.; Nakao, K.; Iwaki, K.; Kondo, M.; Kaihara, S. Three Cases of Boerhaave’s Syndrome Treated via Laparoscopic Transhiatal Esophageal Repair. Case Rep. Gastroenterol. 2022, 16, 406–412. [Google Scholar] [CrossRef] [Scilit]
  412. Kakar, N.; Smith, H.C.; Shadid, A.M. Prolonged Emesis Causing Esophageal Perforation: A Case Report. Cureus 2022, 14, e24720. [Google Scholar] [CrossRef] [Scilit]
  413. Anand, R.; Puckett, Y.; Ronaghan, C.A. Above and Below the Diaphragm: A Previously Undescribed Case of Recurrent Boerhaave Syndrome Diagnosed With Computerized Tomography Esophagram. Cureus 2022, 14, e24015. [Google Scholar] [CrossRef] [Scilit]
  414. Matsuura, N.; Saitou, K. Boerhaave’s Syndrome. Intern. Med. 2022, 61, 265–266. [Google Scholar] [CrossRef] [Scilit]
  415. Tanaka, Y.; Ohno, S.; Sato, Y.; Matsuhashi, N.; Takahashi, T.; Yoshida, K. Subtotal esophagectomy followed by subtotal gastric reconstruction for Boerhaave’s syndrome: Case report with literature review. Int. J. Surg. Case Rep. 2022, 90, 106720. [Google Scholar] [CrossRef] [Scilit]
  416. Tuñon, C.; De Lucas, J.; Cubilla, J.; Andrade, R.; Aguirre, M.; Zúñiga Cisneros, J. Endoluminal vacuum therapy in the management of an esophago-pleural fistula as a complication of Boerhaave syndrome in a patient with eosinophilic esophagitis. BMC Gastroenterol. 2021, 21, 484. [Google Scholar] [CrossRef] [Scilit]
  417. Park, S.B.; Yum, Y.J.; Cha, J.M. Cyanoacrylate injection treatment for postoperative leakage of Boerhaave’s syndrome: A case report. Medicine 2021, 100, e28075. [Google Scholar] [CrossRef] [Scilit]
  418. Simões, J.; Lázaro, A. Transhiatal esophagectomy in Boerhaave syndrome—Case report and literature review. Int. J. Surg. Case Rep. 2021, 89, 106583. [Google Scholar] [CrossRef] [Scilit]
  419. Wang, J.; Wang, D.; Chen, J. Diagnostic challenge and surgical management of Boerhaave’s syndrome: A case series. J. Med. Case Rep. 2021, 15, 553. [Google Scholar] [CrossRef] [Scilit]
  420. Chew, F.Y.; Yang, S.T. Boerhaave syndrome. Can. Med. Assoc. J. 2021, 193, E1499. [Google Scholar] [CrossRef] [Scilit]
  421. Gurgenidze, M.; Magalashvili, D.; Akhmeteli, L.; Nemsadze, G.; Lomidze, N. Management of esophageal perforation: A case report. Georgian Med. News 2021, 318, 28–34. [Google Scholar]
  422. Jagielski, M.; Piątkowski, J.; Jackowski, M. A rare endoscopic image of Boerhaave syndrome in a patient treated with pleural effusion drainage. Pol. Arch. Intern. Med. 2021, 131, 730–731. [Google Scholar] [CrossRef] [Scilit]
  423. Śnieżyński, J.; Wilczyński, B.; Skoczylas, T.; Wallner, G.T. Successful Late Endoscopic Stent-Grafting in a Patient with Boerhaave Syndrome. Am. J. Case Rep. 2021, 22, e931629. [Google Scholar] [CrossRef] [Scilit]
  424. Inoue, T.; Kanesaka, T.; Yamamoto, S.; Tani, Y.; Michida, T.; Ishihara, R. Anchoring Method to Prevent Migration of a Covered, Self-Expanding, Metal Stent Placed for Esophageal Perforation. Am. J. Gastroenterol. 2021, 116, 1582. [Google Scholar] [CrossRef] [Scilit]
  425. Zhu, C.; Castrodad, A.; Santos, A.P. Alternative management of delayed spontaneous oesophageal perforation by endoscopic stenting. BMJ Case Rep. 2021, 14, e244122. [Google Scholar] [CrossRef] [Scilit]
  426. Chen, J.J.; Zhao, W. Boerhaave’s syndrome: A case of spontaneous oesophageal rupture. Indian J. Med. Res. 2021, 154, 156. [Google Scholar] [CrossRef] [Scilit]
  427. Jahangir, A.; Sahra, S.; Anwar, S.; Mobarakai, N.; Jahangir, A. Catastrophic right-sided Candida empyema from spontaneous esophageal perforation. Respir. Med. Case Rep. 2021, 33, 101460. [Google Scholar] [CrossRef] [Scilit]
  428. Zeyara, A.; Jeremiasen, M.; Åkesson, O.; Falkenback, D.; Hermansson, M.; Johansson, J. Third time recurrent Boerhaave’s syndrome: A case report. J. Med. Case Rep. 2021, 15, 223. [Google Scholar] [CrossRef] [Scilit]
  429. Abrahim, M.; AbdelAziz, J. Survival of Boerhaave syndrome against all odds at a rural Emergency Department. Can. J. Rural Med. 2021, 26, 87–90. [Google Scholar] [CrossRef] [Scilit]
  430. Chang, C.W.; Hung, Y.J.; Chan, C.P.; Huang, C.L. Spontaneous esophageal rupture following perforated peptic ulcer: A report of two cases. J. Cardiothorac. Surg. 2021, 16, 57. [Google Scholar] [CrossRef] [Scilit]
  431. Amirian, A.; Shahriarirad, R.; Mardani, P.; Salimi, M. Non-operative management of bilateral contained thoracic esophageal perforation: A case report. BMC Surg. 2021, 21, 129. [Google Scholar] [CrossRef] [Scilit]
  432. Klug, T.D.; Shires, C.B. Contained hypopharyngeal and cervical esophageal perforation masquerading as retropharyngeal abscess. Clin. Case Rep. 2021, 9, 1548–1552. [Google Scholar] [CrossRef] [Scilit]
  433. Awofisoye, O.I.; Olalekan, O.E.; Anumenechi, N.; Onwukpa, F. Boerhaave’s syndrome after pentazocine-induced vomiting in a 21-year-old male with asthma: A case report. Pan Afr. Med. J. 2021, 38, 74. [Google Scholar] [CrossRef] [Scilit]
  434. Ioannidis, O.; Malliora, A.; Christidis, P.; Kotidis, E.; Pramateftakis, M.G.; Mantzoros, I.; Ouzounidis, N.; Foutsitzis, V.; Angelopoulos, S.; Tsalis, K. Conservative treatment of Boerhaave’s syndrome in an octogenarian complicated with late distal esophageal stenosis and successfully treated by stent placement. Cir. Cir. 2021, 89, 23–27. (In English) [Google Scholar] [CrossRef] [Scilit]
  435. Awadelkarim, A.; Shanah, L.; Ali, M.; Alhusain, R.; Adam, O.; Subahi, A.; Yassin, A.S.; Lieberman, R. Esophago-Pericardial Fistulae as a Sequela of Boerhaave Syndrome and Esophageal Stenting: A Case Report and Review of Literature. J. Investig. Med. High. Impact Case Rep. 2021, 9, 23247096211036540. [Google Scholar] [CrossRef] [Scilit]
  436. Wang, C.T.; Jiang, H.; Walline, J.; Li, Y.; Wang, J.; Xu, J.; Zhu, H.D. Tension hydropneumothorax in a Boerhaave syndrome patient: A case report. World J. Emerg. Med. 2021, 12, 235–237. [Google Scholar] [CrossRef] [Scilit]
  437. Ayazi, K.; Samsami, M.; Qaderi, S.; Farsad, S.M.; Tofigh, A.M.; Nematihonar, B.; Tahmasbi, H.; Bagherour, J.Z. Spontaneous perforation as a fatal presentation of esophageal tuberculosis: A case report. Int. J. Surg. Case Rep. 2021, 78, 197–200. [Google Scholar] [CrossRef] [Scilit]
  438. Vermeulen, B.D.; van der Leeden, B.; Ali, J.T.; Gudbjartsson, T.; Hermansson, M.; Low, D.E.; Adler, D.G.; Botha, A.J.; D’Journo, X.B.; Eroglu, A.; et al. Early diagnosis is associated with improved clinical outcomes in benign esophageal perforation: An individual patient data meta-analysis. Surg. Endosc. 2021, 35, 3492–3505. [Google Scholar] [CrossRef] [Scilit]
  439. Biancari, F.; D’Andrea, V.; Paone, R.; Di Marco, C.; Savino, G.; Koivukangas, V.; Saarnio, J.; Lucenteforte, E. Current treatment and outcome of esophageal perforations in adults: Systematic review and meta-analysis of 75 studies. World J. Surg. 2013, 37, 1051–1059. [Google Scholar] [CrossRef] [Scilit]
  440. Predescu, D.; Achim, F.; Socea, B.; Rotariu, A.; Moraru, A.C.; Rasuceanu, A.; Constantin, C.; Rosianu, C.G.; Constantin, A. Boerhaave Syndrome-Narrative Review. Diagnostics 2025, 15, 2463. [Google Scholar] [CrossRef] [Scilit]
  441. Willems, S.; Daemen, J.H.T.; Hulsewé, K.W.E.; Belgers, E.H.J.; Sosef, M.N.; Soufidi, K.; Vissers, Y.L.J.; de Loos, E.R. Outcomes after hybrid minimally invasive treatment of Boerhaave syndrome: A single-institution experience. Acta Chir. Belg. 2023, 123, 369–374. [Google Scholar] [CrossRef] [Scilit]
  442. van Boeckel, P.G.; Dua, K.S.; Weusten, B.L.; Schmits, R.J.; Surapaneni, N.; Timmer, R.; Vleggaar, F.P.; Siersema, P.D. Fully covered self-expandable metal stents (SEMS), partially covered SEMS and self-expandable plastic stents for the treatment of benign esophageal ruptures and anastomotic leaks. BMC Gastroenterol. 2012, 12, 19. [Google Scholar] [CrossRef] [Scilit]
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