Partial oesophageal perforation associated with cold carbonated beverage ingestion

Hui Jern Loh and David A P Cooke
Med J Aust 2004; 181 (10): 554-555.

We present a rare case of spontaneous intramural oesophageal perforation after the rapid ingestion of a cold carbonated beverage. A previously well patient presented with sudden onset of severe retrosternal pain associated with pain on swallowing. A contrast computed tomography scan and gastroscopy confirmed the diagnosis. With the widespread popular practice of drinking cold carbonated beverages, especially during the summer season, clinicians should be aware of this possible serious complication.

A 57-year-old woman presented to the emergency department with retrosternal chest pain of sudden onset immediately after the isolated intake of a large mouthful of cold carbonated beverage directly from the bottle. The initial severe pain led to a brief loss of consciousness. The pain was continuous, exacerbated by swallowing, and accompanied by mild nausea, but no vomiting. She was previously a fit, healthy woman with no past medical history relevant to the case. She was febrile (37.6oC) and distressed by the pain. Examination was normal except for epigastric tenderness with retrosternal radiation. There were no signs of peritonism.

Please login with your free MJA account to view this article in full

  • Hui Jern Loh1
  • David A P Cooke2

  • Department of Surgery, Fremantle Hospital, Fremantle, WA.


Competing interests:

None identified.

  • 1. Boerhaave H. Atrocis, nec descripti prius, morbi historia secundum medicae artis leges conscripta, lugduni batavorum, boutesteniana. Medici 1724; 60. (Translated in Bull Med Libr Assoc 1955; 43: 217-240.)
  • 2. Singh GS, Slovis CM. “Occult” Boerhaave’s syndrome. J Emerg Med 1988; 6: 13-16.
  • 3. Bjerke HS. Boerhaave’s syndrome and barogenic injuries of the esophagus. Chest Surg Clin N Am 1994; 4: 819-825.
  • 4. Younes Z, Johnson DA. The spectrum of spontaneous and iatrogenic esophageal injury. J Clin Gastroenterol 1999; 29: 306-317.
  • 5. Oriscello RG, Mahal P. Gulper’s gullet [letter]. N Engl J Med 1988; 319: 450.
  • 6. Jones WG, Ginsberg RJ. Esophageal perforation: a continuing challenge. Ann Thorac Surg 1992; 53: 534-543.
  • 7. Duncan M, Wong RKH. Esophageal emergencies: things that will wake you from a sound sleep. Gastroenterol Clin North Am 2003; 32: 1035-1052.


remove_circle_outline Delete Author
add_circle_outline Add Author

Do you have any competing interests to declare? *

I/we agree to assign copyright to the Medical Journal of Australia and agree to the Conditions of publication *
I/we agree to the Terms of use of the Medical Journal of Australia *
Email me when people comment on this article

Responses are now closed for this article.