Boerhaave syndrome differential diagnosis

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

Overview

Boerhaave syndrome must be differentiated from other diseases that cause abdominal pain such as Mallory-Weiss syndrome, myocardial infarction, pancreatitis, and peptic ulcer disease.

Differential Diagnosis

 Acute onset of chest or abdominal pain may also be seen with disorders such as:

Diseases	History and Symptoms								Physical Examination				Laboratory Findings			Upper endoscopy
	Hematemesis	Epigastric pain	Light-headedness	Retching	Heartburn	History of medication	Vomiting	History of alcoholism	Tachycardia	Skin Pallor	Hypotension	Weak pulse	Hemoglobin	Platelets	BUN
Mallory-Weiss syndrome	+	+	+ (with heavy bleeding)	+	-	-	+	+	+ (with heavy bleeding)	+ (with heavy bleeding)	+ (with heavy bleeding)	+ (with heavy bleeding)	↓	↓	↑	Tears are usually single and located in the esophagogastric junction, usually extends into the cardia and sometimes into the esophagus
Myocardial infarction	-	+	-	-	-	-	-	-	+	+	+	+
pancreatitis	-	+	-	-	-	+	-	+	-	-	-	-
Peptic Ulcer Disease	-	+	-	-	+	-	-	-	-	-	-	-