Table 2 Major co-morbidities were not greater when diagnosis was delayed <24 h >24 h to presentation to presentation No major co-morbidities 7  7 Major co-morbidities 5 15 <24 h >24 h to presentation to presentation No major co-morbidities 7  7 Major [academic.oup.com]

All clinicians need to be aware of this lethal disease, its frequently unusual presentations and the importance of early diagnosis. [pmj.bmj.com]

To deal with single incident cases, a treatment algorithm is composed and presented in Figure 4. [hindawi.com]

It has traditionally been associated with important vomiting or the Valsalva maneuver, and its clinical presentation is intense pain and emphysema, even though it can present without these symptoms. [revistagastroenterologiamexico.org]

Diagnosis of Boerhaave syndrome can be difficult, because often no classic symptoms are present and delays in presentation for medical care are common. [1] Although Boerhaave syndrome classically presents as the Mackler triad of chest pain, vomiting, [emedicine.medscape.com]

• Fever

  Fever may be present or not. Auscultation occasionally reveals decreased breath sounds on the perforation side. [hindawi.com]

• Respiratory Distress

  However, up to one-third of patients have atypical symptoms or are admitted with severe respiratory distress and/or shock. [hindawi.com]

  Other complications include acute respiratory distress syndrome, pneumomediastinum, pneumothorax, and hydrothorax. Turner AR, Turner SD. Boerhaave syndrome. StatPearls [Internet]. 2018 Jan. [Medline]. [Full Text]. Korn O, Onate JC, Lopez R. [emedicine.medscape.com]

• Dysphagia

  Most treatment options available for the relief or treatment of dysphagia can be performed endoscopically.but can also be caused by Various modalities are currently available for the relief of dysphagia caused by malignant esophageal stricturesThe options [slideshare.net]

It is a rare but life-threatening condition that requires urgent diagnosis and treatment. [hindawi.com]

The current management of Boerhaave syndrome includes conservative, endoscopic and surgical treatments. [ejcrim.com]

The severity of illness was also quite varied, regardless of time interval between injury and treatment. [academic.oup.com]

The choice between surgery or conservative treatment depends on many factors. [revistagastroenterologiamexico.org]

Surgery is the gold standard treatment. However, there is an emerging use of conservative methods, namely esophageal stenting. Mortality can be as low as 6.2% when identified and treated in the first 24 hours 11. [radiopaedia.org]

The combined advancement of medical imaging and surgical techniques have greatly improved the prognosis of these patients especially in case of early treatment. Full article [mjemonline.com]

Early diagnosis governs the appropriate repair and the vial prognosis. [orbi.uliege.be]

[…] and retroperitoneal spaces esophageal perforation from iatrogenic injury Mallory-Weiss tear: partial thickness tear epiphrenic diverticulum: mimicking pneumomediastinum esophageal or pulmonary malignancy causing esophagopleural fistula Treatment and prognosis [radiopaedia.org]

Prognosis The prognosis of Boerhaave syndrome is directly contingent on its early recognition and appropriate intervention. [1] Early diagnosis allows prompt surgical repair. [emedicine.medscape.com]

[…] crucial to correctly distinguish Boerhaave syndrome from Mallory–Weiss syndrome as they share similar etiologies and initial clinical manifestations; however, they differ with respect to the site and depth of laceration, treatment administered, and prognosis [intjem.biomedcentral.com]

The etiologies of both Boerhaave and Mallory–Weiss syndromes are similar, both result from abnormally elevated intraluminal cardio-esophageal pressure during vomiting. [intjem.biomedcentral.com]

Its etiology involves a sudden increase in the intraesophageal pressure. The classic clinical symptoms are vomiting, chest pain, and subcutaneous emphysema, known as Mackler's triad. [revistagastroenterologiamexico.org]

Etiology Boerhaave syndrome is a barogenic injury resulting from a sharp increase in the intraluminal pressure against a closed cricopharyngeus. [emedicine.medscape.com]

Epidemiology, pathophysiology, diagnosis. Pol Przegl Chir 2016;88:359–364. Rokicki M, Rokicki W, Rydel M. Boerhaave's syndrome - over 290 yrs of surgical experiences. Surgical, endoscopic and conservative treatment. Pol Przegl Chir 2016;88:365–372. [ejcrim.com]

Epidemiology International data Although it is likely underreported, the incidence of Boerhaave syndrome is relatively rare, with an estimated incidence of 3.1 per 1,000,000 persons per year. [4] Among esophageal perforations, aproximately 15% are spontaneous [emedicine.medscape.com]

Epidemiology, pathophysiology, diagnosis. Pol Przegl Chir 2016;88:359–364. Rokicki M, Rokicki W, Rydel M. Boerhaave's syndrome - over 290 yrs of surgical experiences. Surgical, endoscopic and conservative treatment. Pol Przegl Chir 2016;88:365–372. [ejcrim.com]

Diagnostic considerations in mediastinal emphysema: a pathophysiologic-roentgenologic approach to Boerhaave's syndrome and spontaneous pneumomediastinum. Am J Roentgenol Radium Ther Nucl Med. 1972 Jul. 115(3):495-511. [Medline]. Rozycki GS. [emedicine.medscape.com]

Regarding pathophysiology, Mallory–Weiss lacerations are caused by repeated retching and primarily involve the part of the gastric cardia that includes the EGJ. [intjem.biomedcentral.com]

The increase in average life expectancy requires a case-by-case approach, where the benefits of invasive manoeuvres and likelihood of discharge are weighed against an acceptable quality of life, aiming to prevent futile medical treatment. [ejcrim.com]

The double-type Niti-S stent (Taewoong Medical)A fully covered inner nitinol stent prevents tumor ingrowth, and an outer uncovered nitinol sleeve in the mid-portion of the stent is meant to prevent migration, thus combining the best properties of both [slideshare.net]

The injury healed after conservative treatment that included rest, no oral consumption, and preventive antibiotics. He was discharged on the 11th day. Fig. 4 Plain CT on arrival in case 2 (a transverse section; b sagittal section). [intjem.biomedcentral.com]

The longer the delay, the more tissue necrosis and oedema are present, perhaps preventing successful repair. [academic.oup.com]