Esophageal surgery: Boerhaave syndrome: practice question

A General Surgery question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Surgery · Esophageal surgery: Boerhaave syndrome

Sample item

After forceful vomiting, a patient develops severe chest pain, subcutaneous emphysema, and systemic toxicity. What diagnosis is most likely?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Spontaneous esophageal rupture

Boerhaave syndrome is a transmural esophageal rupture after forceful emesis, causing mediastinal contamination and sepsis. It requires urgent imaging, resuscitation, antibiotics, and specialist source control.

Option by option

  • A. Spontaneous esophageal rupture (correct)

    Correct. Chest pain and emphysema after vomiting are red flags for perforation.

  • B. Simple gastroesophageal reflux

    Reflux does not cause mediastinal sepsis.

  • C. Mallory-Weiss tear only

    Mallory-Weiss tear causes mucosal bleeding, not full-thickness rupture.

  • D. Acute pericarditis

    Pericarditis causes positional chest pain without post-emetic emphysema.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More General Surgery questions

Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is A, Spontaneous esophageal rupture. Boerhaave syndrome is a transmural esophageal rupture after forceful emesis, causing mediastinal contamination and sepsis.

Why is "Simple gastroesophageal reflux" not the answer?

Reflux does not cause mediastinal sepsis.

Why is "Mallory-Weiss tear only" not the answer?

Mallory-Weiss tear causes mucosal bleeding, not full-thickness rupture.

Why is "Acute pericarditis" not the answer?

Pericarditis causes positional chest pain without post-emetic emphysema.

What concept does this question test?

It tests Esophageal surgery: Boerhaave syndrome in General Surgery. It requires urgent imaging, resuscitation, antibiotics, and specialist source control.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Esophageal surgery: Boerhaave syndrome?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.