CTICasesBoerhaave Syndrome (Esophageal Rupture)
Imaging findings
A chest CT, performed following a chest radiograph that showed reduced lung volumes and retrocardiac abnormalities, reveals extensive pneumomediastinum. Oral contrast administration demonstrates a collection of contrast medium outside the esophagus, specifically along its left anterolateral aspect, confirming an esophageal tear. Associated findings include effusions and surrounding inflammation.
Key takeaways
Boerhaave syndrome, or spontaneous esophageal rupture, is a critical diagnosis that can present with severe chest pain and pneumomediastinum. While often associated with emesis, a minority of patients may present without it. Imaging clues suggestive of esophageal rupture, differentiating it from spontaneous pneumomediastinum, include the presence of pleural effusions, subdiaphragmatic air, and surrounding mediastinal inflammation or consolidation.
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