A rare case of Boerhaave syndrome with cervico-thoracic esophageal junction rupture causing bilateral empyema; case report from Nepal

Abstract

Introduction and importance: Boerhaave syndrome is a rare finding where spontaneous rupture of esophagus occurs, usually in distal segment. It is a life threatening condition that requires urgent surgical intervention.

Case presentation: We present a case of 70 years male who presented with pleural effusion and later empyema following spontaneous rupture of cervico-thoracic junction of esophagus who was managed successfully with primary surgical repair.

Clinical discussion: Although Boerhaave syndrome is tricky to diagnose but it should be considered in all cases with a combination of gastrointestinal and pulmonary signs and symptoms.

Conclusion: Clinical correlation along with imaging such as HRCT chest or gastrografin study is required to come to a diagnosis, however surgical intervention should not be delayed to reduce the mortality.

Keywords: Boerhaave syndrome; Empyema; Esophageal rupture.

Fig. 1

Multiple radiological images of chest X ray, CT scan and gastrografin study with demonstration of pleural effusion, empyema and leak through esophagus respectively.