Which procedure is required for evaluating Boerhaave syndrome?

Evaluating Boerhaave syndrome, which is a spontaneous rupture of the esophagus typically due to severe vomiting, primarily involves the use of esophagogastroduodenoscopy (EGD). This procedure allows direct visualization of the esophagus and can help identify the rupture or other abnormalities in the esophageal lining.

In cases of suspected esophageal perforation, EGD is often preferred as it not only helps in diagnosis but can also facilitate potential therapeutic interventions, such as stenting or drainage if applicable. This direct examination is crucial because it can quickly provide information about the extent of the injury and guide further management strategies.

Other imaging modalities, while useful in certain contexts, do not provide the same level of direct access or therapeutic potential as EGD. For instance, a CT scan can be useful in identifying complications associated with esophageal perforations, but it lacks the ability to directly visualize the esophagus itself. Ultrasound is generally not indicated for esophageal issues, and colonoscopy is not applicable in this context as it examines the colon rather than the esophagus. This makes EGD the most appropriate and effective choice for evaluating Boerhaave syndrome.