Arab Board Surgery Final Written Practice Questions - Arab Board General Surgery Final Written Examination Exam

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A 54-year-old man presents to the emergency department with severe retrosternal and epigastric pain following repeated violent emesis after heavy alcohol consumption. On examination, he is tachycardic, tachypneic, and subcutaneous crepitus is palpable in the suprasternal notch (Mackler triad). What is the most sensitive and initial diagnostic test of choice to confirm Boerhaave syndrome?

Rigid upper gastrointestinal endoscopy Contrast esophagography using water-soluble oral contrast (Gastrografin) or CT esophagography Barium swallow under fluoroscopy as the sole initial study Exploratory left thoracotomy without prior imaging

Correct Answer:

Contrast esophagography using water-soluble oral contrast (Gastrografin) or CT esophagography

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