Spontaneous esophageal perforation (Boerhaave syndrome): CT diagnosis of atypical clinical presentations

Spontaneous esophageal perforation, or Boeehaave syndrome, is an uncommon finding requiring prompt diagnosis and immediate surgery because of its high mortality rate. The clinical diagnosis in typical cases is based on the symptom triad of Macler: vomiting, strong sudden chest pain and subcutaneous emphysema. Finally, the authors finding of a periesophageal mediastinal collection moving to the parietal subpleural space is not reported in the radiological literature. The severity of these findings varies and it is probably related to the increase in intraesophageal pressure affecting the progression of abscessual and hydroaerial collections in different anatomical structures; the time when Computed Tomography is performed is also important. To conclude, The Computed Tomography diagnosis,of spontaneous esophageal rupture is specific and Computed Tomography shows lesion site correctly