'Diagnosis of Boerhaave's Syndrome With Aid of Bedside Ultrasound



      Boerhaave's syndrome is characterized by transmural rupture of the distal esophagus in the setting of increased intraluminal pressures combined with negative intrathoracic pressure. It is a rare condition with high mortality (20–50% mortality rate).

      Case Report

      This is a case of a 47-year-old man who appeared acutely ill, presenting with shortness of breath, chest and abdominal pain, and diagnosed with Boerhaave's syndrome with the assistance of bedside ultrasound.

      Why Should an Emergency Physicians Be Aware of This?

      Emergency physicians must have a heightened suspicion of this diagnosis in patients presenting with chest and abdominal pain and can use bedside ultrasound skills to aid with diagnosis.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Journal of Emergency Medicine
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Turner AR
        • Turner SD.
        Boerhaave syndrome.
        StatPearls. March 2, 2020 (Available at:) (Accessed November 15, 2020)
        • Connelly CL
        • Lamb PJ
        • Paterson-Brown S.
        Outcomes following Boerhaave's syndrome.
        Ann R Coll Surg Engl. 2013; 95: 557-560
        • Martínez-Ordaz JL
        • Cornejo-López GB
        • Blanco-Benavides R.Síndrome de Boerhaave
        Reporte de un caso y revisión de la literatura [Boerhaave's syndrome. Case report and literature review].
        Rev Gastroenterol Mex. 2002; 67: 190-194
        • Pate JW
        • Walker WA
        • Cole Jr, FH
        • Owen EW
        • Johnson WH.
        Spontaneous rupture of the esophagus: a 30-year experience.
        Ann Thorac Surg. 1989; 47: 689-692
        • Spapen J
        • De Regt J
        • Nieboer K
        • Verfaillie G
        • Honoré PM
        • Spapen H.
        Boerhaave's syndrome: still a diagnostic and therapeutic challenge in the 21st century.
        Case Rep Crit Care. 2013; 2013161286
        • Ghanem N
        • Altehoefer C
        • Springer O
        • et al.
        Radiological findings in Boerhaave's syndrome.
        Emerg Radiol. 2003; 10: 8-13
        • American College of Emergency Physicians
        Ultrasound Guidelines: Emergency, Point-of-care, and Clinical Ultrasound Guidelines in Medicine.
        June 2016 (Approved Available at:
        • Zachariah S
        • Gharahbaghian L
        • Perera P
        • Joshi N.
        Spontaneous pneumomediastinum on bedside ultrasound: case report and review of the literature.
        West J Emerg Med. 2015; 16: 321-324
        • Kubodera T
        • Adachi YU
        • Hatano T
        • Ejima T
        • Numaguchi A
        • Matsuda N.
        Subcutaneous emphysema and ultrasound sonography.
        J Intensive Care. 2013; 1: 8
        • Anwar J
        • Maqsood R
        • Soomro S.
        Multimodality imaging approach for the early diagnosis Boerhaave syndrome.
        J Ayub Med Coll Abbottabad. 2017; 29: 157-158
        • Kameda T
        • Taniguchi N.
        Overview of point-of-care abdominal ultrasound in emergency and critical care.
        J Intensive Care. 2016; 4: 53
        • Nazerian P
        • Tozzetti C
        • Vanni S
        • et al.
        Accuracy of abdominal ultrasound for the diagnosis of pneumoperitoneum in patients with acute abdominal pain: a pilot study.
        Crit Ultrasound J. 2015; 7: 15
        • Coppolino F
        • Gatta G
        • Di Grezia G
        • et al.
        Gastrointestinal perforation: ultrasonographic diagnosis.
        Crit Ultrasound J. 2013; 5: S4
        • Chen SC
        • Yen ZS
        • Wang HP
        • Lin FY
        • Hsu CY
        • Chen WJ.
        Ultrasonography is superior to plain radiography in the diagnosis of pneumoperitoneum.
        Br J Surg. 2002; 89: 351-354
        • Beason HF
        • Markowitz JE.
        Pneumomediastinum diagnosed on ultrasound in the emergency department: a case report.
        Perm J. 2015; 19: e122-e124