Boerhaave syndrome out on open waters

Boerhaave syndrome is one of the most fatal causes of sudden thoracic pain. Because of its high mortality early identification and treatment are crucial for patient outcome. The following case describes the occurrence of Boerhaave syndrome in a sailor after being seasick. We outline the management of the case, from the patient’s first treatment in a German island hospital to his transfer via offshore helicopter and, finally, definitive care at the nearest university hospital. Surgical intervention was needed after an initial endoscopic approach had proved insufficient. The patient could eventually be discharged fully cured after a prolonged recovery process. © Anästh Intensivmed 2024.