CLOSTRIDIAL MEDIASTINITIS FOLLOWING BOERHAAVES-SYNDROME

Mediastinitis caused by infection with Clostridium perfringens and spo ntaneous rupture of the esophagus are both life threatening conditions , The combination of these two entities led to septic multiorgan failu re in a 38-year-old woman. The patient was treated successfully by eso phagectomy and postoperative lavage through a partially open abdomen. The lack of information regarding emesis, the leading symptom of Boerh aave's syndrome, caused delayed diagnosis: the triad of emesis, severe epigastric pain and emphysema of the skin was not established until 3 0 h after the onset of symptoms.