Boerhaave syndrome differential diagnosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Differential Diagnosis

 Acute onset of chest or abdominal pain may also be seen with disorders such as myocardial infarction, pancreatitis, peptic ulcer perforation, aortic aneurysm dissection, spontaneous pneumothorax, or pneumonia.

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	-	+	-	-	-	-	-	-	+	+	+	+				Ulcerations are multiple and usually involve the proximal esophagus
pancreatitis	-	+	-	-	-	+	-	+	-	-	-	-				Ulcerations are usually singular and deep
Peptic Ulcer Disease	-	+	-	-	+	-	-	-	-	-	-	-				Ulcerations are usually in distal esophagus, and maybe irregular and multiple