Usually, Boerhaave's syndrome presents as spontaneous esophageal rupture with perforation into the left side of the thorax, nearly always after severe vomiting. The patients typically are in acute distress and have a left-sided pleural effusion.
Treatment usually consists of left-sided thoracotomy, with closure of the tear and flap coverage.
In the case described by Gopalan and Cooke, the patient was treated with bilateral thoracotomy and placement of chest tubes. The radiologic finding consisted of pneumomediastinum, but no extravasation of contrast medium was demonstrated. This report could represent a case of spontaneous pneumomediastinum, whose clinical presentation is identical to that described by Gopalan and Cooke and which has various causes. 6020 Innsbruck, Austria References 1 . Return to Text 2 .