Boerhaave syndrome history and symptoms

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Mohamed Diab, MD [2], Ajay Gade MD[3]], Feham Tariq, MD [4]


The clinical manifestations of Boerhaave syndrome (BHS) depend on the location of the perforation. Boerhaave syndrome often presents with excruciating retrosternal chest pain due to an intrathoracic esophageal perforation. Boerhaave syndrome is classically associated with a history of severe retching and vomiting. However, 25 to 45 percent of patients have no history of vomiting.

History and Symptoms

The history and symptoms are as follows:[1][2][3][4][5]


  • Obtaining history gives important information in making a diagnosis of BHS.
  • It provides insight into the cause, precipitating factors, and associated comorbid conditions.
  • A complete history will help determine the correct therapy and determining the prognosis.
  • The areas of focus should be on onset, duration, and progression of symptoms such as



  1. McGovern M, Egerton MJ (1991). "Spontaneous perforation of the cervical oesophagus". Med. J. Aust. 154 (4): 277–8. PMID 1994204.
  2. Wilson RF, Sarver EJ, Arbulu A, Sukhnandan R (1971). "Spontaneous perforation of the esophagus". Ann. Thorac. Surg. 12 (3): 291–6. PMID 5112482.
  3. Woo KM, Schneider JI (2009). "High-risk chief complaints I: chest pain--the big three". Emerg. Med. Clin. North Am. 27 (4): 685–712, x. doi:10.1016/j.emc.2009.07.007. PMID 19932401. Unknown parameter |month= ignored (help)
  4. Pate JW, Walker WA, Cole FH, Owen EW, Johnson WH (1989). "Spontaneous rupture of the esophagus: a 30-year experience". Ann. Thorac. Surg. 47 (5): 689–92. PMID 2730190.
  5. Brauer RB, Liebermann-Meffert D, Stein HJ, Bartels H, Siewert JR (1997). "Boerhaave's syndrome: analysis of the literature and report of 18 new cases". Dis. Esophagus. 10 (1): 64–8. PMID 9079278.

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