0 Boerhaave's syndrome vs Mallory–Weiss syndrome

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Boerhaave's syndrome vs Mallory–Weiss syndrome



Boerhaave's syndrome


Mallory–Weiss syndrome


Site :  Lower thoracic oesophagus


Site: Vertical tear in cardia of stomach , may extend to distal oesophagus.


There is vertical perforation, and all gastric content goes into mediastinum.
No history of foreign body.

Mackler's triad may be seen :
  • Chest pain, 
  • vomiting and 
  • subcutaneous emphysema



Mucosa and submucosa are involved, NOT a complete perforation.
Presentation : Hematemesis (Not pain)

Reason : Vomiting / Retching against closed cricopharynx. i.e barotrauma


Reason : Vomiting , Increased LES (Lower esophageal sphincter)  pressure. –  can cause tear.

Sign : Air in mediastinum

Hamman’s Sign  (seen with any cause of pneumomediastinum.) – On auscultation , because of air around heart.

Investigation of Choice : Water soluble contrast study ( DO NOT USE BARIUM)


Diagnosis : Upper GI endoscopy.



Treatment : Immediate surgery
(via LEFT thoracotomy )

If >24-48 hrs – Let heal with secondary intention , do not suture , Just put a drain.


Treatment : Conservative (95 % cases)






MedicoNotebook - Founder : DrShiviMudgal , Co-Founder : DrAyushGoel

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