Boerhaave Syndrome: Case Report on a Rare Complication of Semaglutide Use

Esophageal perforation is a rare but life-threatening condition with high morbidity and mortality, particularly when diagnosis is delayed.Boerhaave syndrome, a spontaneous esophageal rupture often triggered by forceful emesis, can present variably and is frequently difficult to recognize early.We report the case of a 62-year-old female patient who developed Boerhaave syndrome two days after initiating semaglutide therapy for weight loss.She presented with intractable nausea, vomiting, and acute chest pain.The chest CT was concerning for esophageal perforation.She rapidly deteriorated into hypoxemic respiratory failure and septic shock.She underwent emergent thoracotomy with primary repair of the perforation.She continued to be treated for septic shock in the ICU, but ultimately she recovered and was discharged on hospital day 17.As GLP-1 use continues to expand, clinicians should maintain awareness of rare but life-threatening complications such as Boerhaave syndrome, as early recognition, prompt imaging, and timely surgical intervention are critical to improving outcomes.