Boerhaave's syndrome is due to:

(Spontaneous perforation) (999-Baily & Love 20th) (472-CSDT 12th) (1014-B & L 25th)Spontaneous (Postemetic) perforation (Boerhaave's syndrome)* Spontaneous perforation usually occurs in the absence of prexisting esophageal disease, but 10% of patients have reflux esophagitis, esophageal diverticulum, carcinoma etc.* The rupture usually involves all layers of the esophagus wall and most frequently occurs in the left postreolatral aspect 3-5 cm above the gastroesophageal junctions.* The tear results from excessive intraluminal pressure, usually caused by violent retching and vomiting.MALLORY-WE1SS-SYNDROME - Vigourous vomiting produces a vertical split that is in the gastric mucosa. About 75% of these lesions are confined to the stomach. Majority of patients are alcoholics.* Medical instrumentation is the most common cause of esophageal perforation (diagnostic or therapeutic endoscopy)* The cricopharengeal area is the most common site of injury.* Most common site of perforation at the natural site of narrowing at the level of the left main bronchus and at the diaphragmatic hiatus.