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The complete atraumatic rupture of an intact esophageal wall had been described first by Boerhaave in 1724. We reviewed 424 published cases from that time until 1985 regarding the clinical feature and different types of diagnosis and treatment. An over all mortality rate between 28 and 85% was found which is highly influenced by the time the right diagnosis is made and by the choice of treatment. It is demonstrated that only an early diagnosis followed by immediate surgery (suture of the perforation protected by a pleural flap) can improve the poor prognosis of this illness.
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