Boerhave Syndrom Revealed by Pneumediastinum and Subcutaneous Emphysema: About One Case

Abstract

The Boerhaave syndrom or spontaneous rupture of the esophagus is a rare pathology that represents 15% of all esophagus ruptures, caused by a sudden increase pressure in intraluminale due to the vomiting efforts. The pronostic depends of the early instauration of the adapted treatment. We report the case of a 35 years old patient who showed a provoked repetitive vomiting since one month. He consulted at the pneumology service because of brutal thoracic pain since 4 days associated to a violent epigastralgical, complicated three hours after a respiratory distress. The clinical exam oriented us to the esophagus ruptur hyposthesis (Boerhaave syndrom) confirmed by the imagery that showed the presence of an pneumomediastinum, an hydropneumothorax, an important emphysema dissecting soft tissue, and a clear distension of the lower border of the thoracical esophagus. In front the aggravation of the respiratory difficulty, the patient was transfered to the intensive care service.