Survival after Esophageal Rupture during the COVID Pandemic: The Evolution of a Mallory Weiss Tear to Boerhaave’s Syndrome

We present the case of a 42-year-old male cirrhotic chronic alcoholic who was admitted during height COVID pandemic with large right pleural effusion. Thorough investigation revealed right-sided distal esophageal rupture near gastroesophageal junction and he diagnosed Mallory Weiss tear converted to Boerhaave’s syndrome. He successfully underwent endoscopic placement covered stent, but had protracted recovery presumed empyema continuing require chest tube drainage. eventually required surgical intervention thoracotomy, decortication, wash out. Our provides an excellent example risk distraction global secondary nonspecific symptomatology being attributed COVID-19 significant critical care requirements leading delay in diagnosis rupture. However, our patient is also uniquely impressive when compared similarly published cases conversion Syndrome given his survival clinical outcome discharge home on oral diet despite increased morbidity based prolonged illness disease course.