Effort Rupture of the Oesophagus (Boerhaave's Syndrome)

Boerhaave's Syndrome is a rare condition that develops when the distal oesophagus ruptures, resulting in a high risk of morbidity and fatality. Oesophageal perforations are rare, with an incidence of 3.1 per 1,000,000 per year. Patients with a normal underlying oesophagus are more likely to develop Boerhaave's syndrome. A portion of patients with Boerhaave's syndrome, however, have underlying eosinophilic esophagitis, medication-induced esophagitis, Barrett's disease, or infectious ulcers. A longitudinal oesophageal perforation occurs when a sudden increase in intra-oesophageal pressure is paired with negative intrathoracic pressure, as in severe straining or vomiting, and less frequently in childbirth, seizure, continuous coughing or laughing, or weightlifting.