Boerhaave syndrome is a rare condition with full-thickness spontaneous rupture of the esophagus after forceful emesis. We report a case treated for Boerhaave Syndrome in our centre. A CT scan was performed and described the presence of left penumothorax, pleural effusion, gastrectasia with food ingested inside and air bubbles around the distal esophagus. We inserted a chest tube and a nasogastric tube which collected the same gastric fluids. CT with administration of gastrografins confirmed the presence of a perforation of the esophagus distal portion with all the contrast poured into the thorax. A laparoscopic exploration was performed. It confirmed the site of the perforation at the distal posterior left esophagus and a hole of about 4 cm that was sutured. The mediastinum was drained through the abdominal approach and the pleural cavity through a thoracotomy which consented the removal of the food ingested. Finally an enterostomy was performed. The patient was finally dismissed after 17 days of hospitalization with progressive recovery and oral soft diet well tolerated. Time is a key point in the treatment of esophageal perforation due to Boerhaave syndrome: the time of presentation to the hospital, the time between the onset of symptoms , diagnosis and treatment. The delay in diagnosis explains the high mortality rate of this pathology up to 40-60% in patients treated at 48 hours. The prognosis improves if treatment, surgical and medical, is granted within the first 24 hours.

Doctor Soldini is a General Surgeon and currently Head of the Emergency and Surgical Admissions Unit at the Moriggia-Pelascini Hospital in Gravedona. He worked primarily in emergency and trauma surgery at a highly specialized trauma centre, whilst also working as a transplant surgeon. Following this period, he moved into advanced laparoscopic surgery. Recently he served as Venue Medical Officer (medical director and coordinator) for the Aerials & Moguls Olympic Venue in Livigno for Milano-Cortina 2026 Winter Olympics, and he is the Chief Medical Officer for the Italian leg of the UCI MTB and Downhill World Championships.