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Boerhaave-Mimicking Esophageal Perforation with Subsequent Esophagobronchial Fistula Formation as the Primary Manifestation of Crohn’s Disease

Background: Spontaneous ruptures of the esophagus are rare, but may lead to deleterious courses, even if diagnosed early. Case Report: We report a case of Boerhaave’s syndrome-mimicking esophageal perforation due to a stricture of the distal esophagus as the primary manifestation of Crohn’s disease. Diagnosis was delayed resulting in a complicated clinical course. The presented patient is the first case in the literature with esophageal perforation related to a previously undiagnosed Crohn’s disease that lead to stenosis of the distal esophagus before becoming clinically apparent. Conclusion: Difficulties in differential diagnosis, problems related to initial misdiagnosis and consecutive mismanagment of spontaneous esophageal perforation, and treatment options including nonsurgical approaches are discussed.