Boerhaave syndrome pathophysiology

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

Pathophysiology

• Boerhaave syndrome is a spontaneous perforation of the esophagus due to a sudden rise in intraesophageal pressure combined with negative intrathoracic pressure (eg, severe straining, vomiting or seizures) as a result of neuromuscular incoordination.

• Boerhaave syndrome is commonly associated with the consumption of excessive food and/or alcohol.

• Boerhaave syndrome usually occurs in patients with a normal underlying esophagus, some patients with Boerhaave syndrome has underlying medication-induced esophagitis, eosinophilic esophagitis, Barrett's or infectious ulcers.

• The most common anatomical location of the esophageal perforation in Boerhaave syndrome is at left posterolateral wall of the distal intrathoracic esophagus, 2-3 cm before the stomach. However, the esophageal perforation in Boerhaave syndrome can occur in the cervical or intra-abdominal esophagus.