Boerhaave's syndrome: spontaneous rupture of the oesophagus.

A review of nine patients with spontaneous rupture of the oesophagus is presented. All patients had mediastinal or pleural air or fluid on x-ray, but a diagnostic error was made in five of them leading to postponed treatment and a fatal outcome from mediastinitis. Of the remaining four patients two recovered and left hospital while another two died of vascular and respiratory complications. Clinical signs and treatment are discussed and early diagnosis emphasized in order to reduce the high mortality.