CTChestAdvanced

Boerhaave syndrome

oesophaguschestperforationemergencypneumomediastinumgastrointestinal

Clinical presentation

Middle-aged patient with severe retrosternal pain and subcutaneous emphysema following an episode of forceful vomiting.

Key imaging findings

  • Pneumomediastinum and left pleural effusion / hydropneumothorax
  • Oesophageal wall defect, typically the left posterolateral distal oesophagus
  • Extravasation of oral contrast into the mediastinum or pleura
  • Mediastinal fluid and gas locules on CT

Form your diagnosis, then reveal the answer.

Educational teaching content only. Imaging appearances vary; always correlate clinically and confirm with a qualified radiologist.