A 60-year-old has sudden severe epigastric pain after repeated vomiting. He is toxic, has subcutaneous emphysema at the neck, left pleural effusion

Question

A 60-year-old has sudden severe epigastric pain after repeated vomiting. He is toxic, has subcutaneous emphysema at the neck, left pleural effusion on chest X-ray and lactate 4.0 mmol/L. What is the most likely diagnosis?

Accepted Answer

Boerhaave syndrome

Answer

Uncomplicated Mallory-Weiss tear

Answer

Renal colic

Answer

Viral gastroenteritis

Answer

Acute coronary syndrome without perforation

Boerhaave syndrome — RCPSC EM MCQ

A 60-year-old has sudden severe epigastric pain after repeated vomiting. He is toxic, has subcutaneous emphysema at the neck, left pleural effusion on chest X-ray and lactate 4.0 mmol/L. What is the most likely diagnosis?