Diagnosing Boerhaave Syndrome in a 16-year-old girl in a primary care centre

Abstract

Boerhaave syndrome is the spontaneous rupture of the oesophagus due to raised intra-oesophageal pressure and is a potentially fatal condition. The patient often presents with retrosternal chest pain and upper abdominal pain associated with significant history of retching and vomiting. The condition has a mortality rate of up to 40% hence early diagnosis and timely intervention is crucial. This emergency is rarely seen in children and young adolescents. We report a case of Boerhaave syndrome in a 16-year-old girl who presented to a primary care setting with vomiting, abdominal pain, and subcutaneous emphysema. The diagnosis of oesophageal rupture was made clinically. Thus, immediate referral to secondary care was vital in providing urgent management. This discussion highlights that this emergency can present in younger age adolescents, therefore high index of suspicion is imperative for good prognosis. Key words: Boerhaave syndrome, oesophageal perforation