Boerhaave's syndrome: a pediatric case.
BACKGROUND: The term Boerhaave's syndrome refers to esophageal rupture after a sudden increase in intraluminal pressure. This syndrome is most common among alcoholic adult men. This case report is that of a pediatric patient with a similar pathologic process. STUDY: A 6-month-old Hispanic boy with acute lymphoblastic leukemia on chemotherapy arrested 3 weeks into his induction therapy. Diagnostic and therapeutic procedures revealed a hydropneumothorax, which was managed with chest tube drainage. The underlying etiology was revealed 10 days later when feeds were introduced and found exiting the chest tube. A contrast study confirmed esophageal perforation, which was surgically repaired. CONCLUSION: A nontraumatic hydropneumothorax should raise the possibility of Boerhaave's syndrome (spontaneous esophageal rupture), even in pediatric patients. Such a finding warrants a contrast study to facilitate early diagnosis.