ABSTRACT
@#The clinical presentation of Boerhaave’s syndrome (BS), a rare condition of the gastrointestinal tract characterized by a spontaneous rupture of the esophagus most often caused by vomiting after excessive alcohol drinking or after consuming a large meal, mimics other less serious illnesses, often leading to a missed or delayed diagnosis. The Mackler triad, which is rare and pathognomonic of BS, includes lower thoracic or chest pain, subcutaneous emphysema, and vomiting. Diagnosis is made through computed tomography scan and esophageal contrast studies. Treatment of BS is geared towards control of mediastinitis and sepsis, and repair of the perforation or reestablishment of the continuity of the gastrointestinal tract. We report the case of a 46-year-old male with BS, who was initially managed with a conservative resection of the perforated esophagus 48 hours after the onset of symptoms. When the mediastinitis persisted we decided to do a subtotal esophagectomy and subsequent esophageal reconstruction.