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Boerhaave syndrome — RCPSC EM MCQ

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ModerateGI/Abdominal emergenciesBoerhaave syndromeRCPSC EM

A 49-year-old develops sudden severe chest and epigastric pain after repeated vomiting. He is febrile, tachycardic, and has crepitus in the neck. Chest radiograph shows left pleural effusion and mediastinal air. What is the most likely diagnosis?

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Correct answer: C — Boerhaave syndrome

Boerhaave syndrome is correct: the clues indicate Boerhaave syndrome and this option addresses the immediate ED priority. The distractors delay care, target a less likely problem, or are unsafe in this physiology.

Reference: Rosen's Emergency Medicine; thoracic emergency practice