title: Boerhaave's syndrome secondary to an incarcerated inguinal hernia: A case report.
abstract: BACKGROUND
  Boerhaave's syndrome is defined as the spontaneous perforation of the esophagus. Although it has been reported in association with different gastrointestinal pathologies, there are no previous reports in association with an incarcerated inguinal hernia containing ischemic small bowel.
  
  
  METHODS
  We present an unusual case of a gentleman who presented with severe chest pain after a 24-h period of emesis. He was found to have developed an esophageal perforation presumed secondary to an incarcerated inguinal hernia causing small bowel obstruction. The patient underwent a thoracotomy to repair the perforated esophagus followed by a groin exploration, small bowel resection and repair of the inguinal hernia.
  
  
  CONCLUSIONS
  Boerhaave's syndrome is well known to be a postemetic phenomenon in association with upper gastrointestinal obstruction. However, to our knowledge, this is the first reported case of esophageal perforation secondary to strangulated bowel in an inguinal hernia. In similar situations, we recommend the surgical correction of the esophageal perforation, followed by exploration and resection of any ischemic small bowel.
  
  
  CONCLUSIONS
  Here we present a patient who was diagnosed with a perforated esophagus after forceful emesis secondary to an incarcerated inguinal hernia containing ischemic bowel.
authors.affiliation: Division of Thoracic Surgery, Ottawa Hospital, General Campus, 501 Smyth Road, Ottawa, Ontartio, K1H 8L6, Canada; UBC Department of Surgery, Faculty of Medicine, 950 West 10th Ave., Vancouver, British Columbia, V5Z 1M9, Canada. Electronic address: logari1@yahoo.ca.
authors.forename: Ahmad S
authors.initials: AS
authors.lastname: Ashrafi
authors.affiliation: UBC Department of Surgery, Faculty of Medicine, 950 West 10th Ave., Vancouver, British Columbia, V5Z 1M9, Canada. Electronic address: michael.horkoff@gmail.com.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Horkoff
authors.affiliation: Division of General Surgery, Ottawa Hospital, General Campus, 501 Smyth Road, Ottawa, Ontario, K1H 8L6, Canada.
authors.forename: Waleed M
authors.initials: WM
authors.lastname: Mohammad
authors.affiliation: Division of General Surgery, Ottawa Hospital, General Campus, 501 Smyth Road, Ottawa, Ontario, K1H 8L6, Canada.
authors.forename: Shaheer
authors.initials: S
authors.lastname: Tadros
authors.affiliation: Division of Thoracic Surgery, Ottawa Hospital, General Campus, 501 Smyth Road, Ottawa, Ontartio, K1H 8L6, Canada.
authors.forename: Sudhir
authors.initials: S
authors.lastname: Sundaresan
keywords: Boerhaave’s syndrome; CT; Case report; Esophageal perforation; Hernias; Ischemia; computed tomographic