Anaesthetic Challenges in Boerhaave Syndrome with Delayed Diagnosis

Boerhaave syndrome is the spontaneous rupture of the esophagus, most commonly the left lower third of the esophagus, mainly due to increased intraluminal esophageal pressure after straining. The classic triad of symptoms includes vomiting, lower thoracic pain, and subcutaneous emphysema. A 45-year-old male patient presented with vomiting and lower chest pain after heavy alcohol intake. He was diagnosed with Boerhaave syndrome by contrast-enhanced computed tomography. The patient was given a bronchial blocker with an ambuscope as a backup for one-lung ventilation. An emergency operation was done with resection of the perforated part with esophagogastric anastomosis.