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Diagnosis

Authoring team

The diagnosis of Boerhaave's syndrome is made after:

  • chest X-ray:
    • after a few hours, air and fluid in the pleural cavity
    • mediastinal emphysema
    • in up to 20% of cases, the 'Nacleario V-sign' may be seen as radiolucent streaks that dissect the retrocardiac fascia to form the letter V. This is a specific but insensitive radiographic sign of oesophageal perforation.
  • contrast studies: definitive diagnosis made with gastrograffin swallow to show the site of the perforation
  • CT scanning. CT findings may include periesophageal and mediastinal gas, mediastinal fluid collections, oesophageal wall thickening, pleural effusion, pneumothorax, and hydrothorax. (1)

Reference

  1. Tonolini M, Bianco R. Spontaneous esophageal perforation (Boerhaave syndrome): Diagnosis with CT-esophagography. J Emerg Trauma Shock. 2013 Jan;6(1):58-60.

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The content herein is provided for informational purposes and does not replace the need to apply professional clinical judgement when diagnosing or treating any medical condition. A licensed medical practitioner should be consulted for diagnosis and treatment of any and all medical conditions.

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