title: Boerhaave-mimicking esophageal perforation with subsequent esophagobronchial fistula formation as the primary manifestation of Crohn's disease.
abstract: BACKGROUND
  Spontaneous ruptures of the esophagus are rare, but may lead to deleterious courses, even if diagnosed early.
  
  
  METHODS
  We report a case of Boerhaave's syndrome-mimicking esophageal perforation due to a stricture of the distal esophagus as the primary manifestation of Crohn's disease. Diagnosis was delayed resulting in a complicated clinical course. The presented patient is the first case in the literature with esophageal perforation related to a previously undiagnosed Crohn's disease that lead to stenosis of the distal esophagus before becoming clinically apparent.
  
  
  CONCLUSIONS
  Difficulties in differential diagnosis, problems related to initial misdiagnosis and consecutive mismanagment of spontaneous esophageal perforation, and treatment options including nonsurgical approaches are discussed.
authors.affiliation: Department of Surgery, University Hospital Eppendorf, Hamburg, Germany.
authors.forename: E
authors.initials: E
authors.lastname: Yekebas
authors.forename: C
authors.initials: C
authors.lastname: Busch
authors.forename: N
authors.initials: N
authors.lastname: Soehendra
authors.forename: O
authors.initials: O
authors.lastname: Winzer
authors.forename: X
authors.initials: X
authors.lastname: Rogiers
authors.forename: J R
authors.initials: JR
authors.lastname: Izbicki
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001983:Bronchial Fistula / Q000209:etiology* / Q000601:surgery; D003251:Constriction, Pathologic; D003424:Crohn Disease / Q000150:complications*; D004937:Esophageal Fistula / Q000209:etiology* / Q000601:surgery; D004939:Esophageal Perforation / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D004947:Esophagus / Q000473:pathology; D006801:Humans; D008297:Male; D012422:Rupture, Spontaneous; D013577:Syndrome