Abstract

In this case report we present a young, healthy male, presenting to hospital 5 days after ingesting Roundup®, a glyphosate-containing herbicide. His main complaints included haematemesis, pleuritic chest pain and dyspnoea. Initial assessment revealed a Left Pneumothorax (PTX) for which an intercostal drain (ICD) was inserted. On further evaluation he had Acute Kidney Injury (AKI), toxic hepatitis and developed a right sided PTX on the third day of admission. Pneumomediastinum was identified on follow-up chest x-ray (CXR). These findings, in conjunction with his presenting complaints and the clinical finding of Hamman’s crunch on auscultation, a diagnosis of Boerhaave’s syndrome was postulated, which was confirmed on contrast enhanced Computed Tomography (CT) of the chest with swallow. A brief overview of glyphosate toxokinetics and Boerhaave’s syndrome is provided.

Keywords: Glyphosate; Boerhaave’s syndrome; pneumomediastinum; Oesophageal perforation