Boerhaave syndrome presenting as massive hemothorax

Boerhaave syndrome is a rare entity which classically pre- sents with perforation and mediastinal sepsis. The patients' outcome is directly related to the length of time required to diagnose and surgically address the syndrome. Atypical presentations can contribute to a delay in recognizing the phenomenon, which portends poorly. The case of a man with postemetic esophageal perforation presenting with a massive left hemothorax is presented. To the authors' knowledge, this is the only case of this type to be described in the literature.