{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,13]],"date-time":"2026-09-13T17:03:20Z","timestamp":1789319000932,"version":"build-2803163510"},"reference-count":4,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T00:00:00Z","timestamp":1788307200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,9,2]]},"abstract":"<jats:title>SUMMARY<\/jats:title>\n                  <jats:p>Boerhaave syndrome is a rare surgical emergency, defined as a spontaneous perforation of the esophagus. Treatment options include endoscopic intervention and\/or surgery, but the morbidity and mortality associated with Boerhaave syndrome is high. No consensus-based treatment guidelines currently exist. The aim of this study was to evaluate the diversity in treatment strategies for different clinical scenarios of Boerhaave syndrome across Europe. Forty-four surgeons from 24 different esophageal tertiary centers across nine European countries, Australia and the United Kingdom were invited to participate in this case-vignette study. Each surgeon was presented with four different cases of patients with Boerhaave syndrome and asked for their choice of initial treatment using a multiple-choice questionnaire. A multivariable regression analysis was performed to identify predictors of treatment choice. Thirty-one surgeons from 21 centers (20 in Europe across 9 countries and 1 in Australia) participated in the study. The proportion of surgeons selecting endoscopic treatment varied across the four cases (45%\u201384%, P\u2009&amp;lt;\u20090.01). Endoscopic treatment was associated with younger patient age (OR 0.83, 95% CI [0.75, 0.92], P\u2009&amp;lt;\u20090.01), absence of sepsis (OR 0.11, 95% CI [0.00, 0.16], P\u2009&amp;lt;\u20090.01) and increased time to treatment (OR 1.97, 95% CI [1.17, 3.31], P\u2009=\u20090.01). All surgeons working at Nordic centers (N\u2009=\u20096) exclusively opted for endoscopic treatment. We found considerable diversity in treatment strategies among surgeons presented with identical cases of patients with Boerhaave syndrome. Notably, all surgeons working at a Nordic center selected endoscopic treatment as their initial treatment strategy in all four cases.<\/jats:p>","DOI":"10.1093\/dote\/doag100","type":"journal-article","created":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T11:40:05Z","timestamp":1787658005000},"source":"Crossref","is-referenced-by-count":0,"title":["The current management of Boerhaave syndrome\u2014a European multicenter case-vignette study"],"prefix":"10.1093","volume":"39","author":[{"given":"Tobias","family":"Hauge","sequence":"first","affiliation":[{"name":"Department of Gastrointestinal Surgery, Oslo University Hospital, Ullev\u00e5l , Oslo ,","place":["Norway"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aram Abu","family":"Hejleh","sequence":"additional","affiliation":[{"name":"Department of General, Visceral, Thoracic and Transplantation Surgery, University of Cologne ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7764-6075","authenticated-orcid":false,"given":"Alberto","family":"Aiolfi","sequence":"additional","affiliation":[{"name":"Division of General and Foregut Surgery, IRCCS Policlinico San Donato, University of Milan , Milan ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4880-1670","authenticated-orcid":false,"given":"Luigi","family":"Bonavina","sequence":"additional","affiliation":[{"name":"Division of General and Foregut Surgery, IRCCS Policlinico San Donato, University of Milan , Milan ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lena-Christin","family":"Conradi","sequence":"additional","affiliation":[{"name":"Department of General, Visceral and Pediatric Surgery, University Medical Center G\u00f6ttingen , G\u00f6ttingen ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6747-4583","authenticated-orcid":false,"given":"Xavier Benoit","family":"D'Journo","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Diseases of the Esophagus & Lung Transplantations, Chemin des Bourrely, North Hospital , Marseille ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2172-5310","authenticated-orcid":false,"given":"David","family":"Edholm","sequence":"additional","affiliation":[{"name":"Department of Surgery, Link\u00f6ping University , Link\u00f6ping ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessie","family":"Elliot","sequence":"additional","affiliation":[{"name":"Department of Surgery, Trinity St. James Cancer Institute, Trinity College Dublin & St. James\u2019s Hospital , Dublin ,","place":["Ireland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzanne S","family":"Gisbertz","sequence":"additional","affiliation":[{"name":"Department of Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands and Cancer Center Amsterdam , Amsterdam ,","place":["the Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian Alexander","family":"Gutschow","sequence":"additional","affiliation":[{"name":"Department of Visceral and Transplant Surgery, University Hospital Zurich , Zurich ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shantanu","family":"Joglekar","sequence":"additional","affiliation":[{"name":"Department of Surgery, University Hospital Geelong, Barwon Health , Geelong, VIC ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1695-4103","authenticated-orcid":false,"given":"Fredrik","family":"Klevebro","sequence":"additional","affiliation":[{"name":"Division of Surgery and Oncology, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet and Department of Upper Abdominal Diseases, Karolinska University Hospital , Stockholm \u00a0","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9483-1520","authenticated-orcid":false,"given":"Misha","family":"Luyer","sequence":"additional","affiliation":[{"name":"Department of Surgery, Catharina Hospital , Eindhoven ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tom","family":"Mala","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal Surgery, Oslo University Hospital, Ullev\u00e5l , Oslo ,","place":["Norway"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucia","family":"Moletta","sequence":"additional","affiliation":[{"name":"Department of Surgery, Oncology and Gastroenterology, University Hospital of Padova , Padova ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0475-9538","authenticated-orcid":false,"given":"Henrik","family":"Nienh\u00fcser","sequence":"additional","affiliation":[{"name":"Department of General, Visceral and Transplantation Surgery, Heidelberg University Hospital , Heidelberg ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philippe","family":"Nafteux","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, University Hospitals Leuven , Leuven ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8230-5649","authenticated-orcid":false,"given":"Lieven","family":"Depypere","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, University Hospitals Leuven , Leuven ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia","family":"Nezi","sequence":"additional","affiliation":[{"name":"Department of Surgery, Oncology and Gastroenterology, University Hospital of Padova , Padova ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5837-5513","authenticated-orcid":false,"given":"Grard","family":"Nieuwenhuijzen","sequence":"additional","affiliation":[{"name":"Department of Surgery, Catharina Hospital , Eindhoven ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Franziska","family":"Renger","sequence":"additional","affiliation":[{"name":"Department of Surgery, University Medical Centre, Johannes Gutenberg University Mainz , Mainz ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1859-9213","authenticated-orcid":false,"given":"Peter","family":"Grimminger","sequence":"additional","affiliation":[{"name":"Department of Surgery, University Medical Centre, Johannes Gutenberg University Mainz , Mainz ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0774-1904","authenticated-orcid":false,"given":"Ioannis","family":"Rouvelas","sequence":"additional","affiliation":[{"name":"Division of Surgery and Oncology, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet and Department of Upper Abdominal Diseases, Karolinska University Hospital , Stockholm \u00a0","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jelle P","family":"Ruurda","sequence":"additional","affiliation":[{"name":"Department of Surgery, University Medical Center Utrecht, Utrecht University , Utrecht ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcel A","family":"Schneider","sequence":"additional","affiliation":[{"name":"Department of Visceral and Transplant Surgery, University Hospital Zurich , Zurich ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela Polette","family":"Stubb","sequence":"additional","affiliation":[{"name":"Division of Surgery and Oncology, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet and Department of Upper Abdominal Diseases, Karolinska University Hospital , Stockholm \u00a0","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1462-8275","authenticated-orcid":false,"given":"Michele","family":"Valmasoni","sequence":"additional","affiliation":[{"name":"Department of Surgery, Oncology and Gastroenterology, University Hospital of Padova , Padova ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark I van","family":"Berge Henegouwen","sequence":"additional","affiliation":[{"name":"Department of Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands and Cancer Center Amsterdam , Amsterdam ,","place":["the Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0336-4179","authenticated-orcid":false,"given":"Elke van","family":"Daele","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal Surgery, Ghent University Hospital , Ghent ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7134-261X","authenticated-orcid":false,"given":"Richard van","family":"Hillegersberg","sequence":"additional","affiliation":[{"name":"Department of Surgery, University Medical Center Utrecht, Utrecht University , Utrecht ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1883-6186","authenticated-orcid":false,"given":"Hanne","family":"Vanommeslaeghe","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal Surgery, Ghent University Hospital , Ghent ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie","family":"Veziant","sequence":"additional","affiliation":[{"name":"Department of Digestive and Oncological Surgery, Lille University Hospital , Lille ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4738-3697","authenticated-orcid":false,"given":"Bas","family":"Wijnhoven","sequence":"additional","affiliation":[{"name":"Department of Surgery, Erasmus MC Cancer Institute, Erasmus University Medical Centre , Rotterdam ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6171-4427","authenticated-orcid":false,"given":"Christiane J","family":"Bruns","sequence":"additional","affiliation":[{"name":"Department of General, Visceral, Thoracic and Transplantation Surgery, University of Cologne ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6215-8132","authenticated-orcid":false,"given":"Magnus","family":"Nilsson","sequence":"additional","affiliation":[{"name":"Division of Surgery and Oncology, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet and Department of Upper Abdominal Diseases, Karolinska University Hospital , Stockholm \u00a0","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wolfgang","family":"Schr\u00f6der","sequence":"additional","affiliation":[{"name":"Department of General and Visceral Surgery, Helios University Hospital Wuppertal , Wuppertal ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,9,13]]},"reference":[{"key":"2026091312053727500_ref1","author":"George Triadafilopoulos","year":"2023"},{"key":"2026091312053727500_ref2","doi-asserted-by":"crossref","first-page":"476","DOI":"10.1055\/s-0030-1250347","article-title":"Oesophageal perforations in Iceland: a whole population study on incidence, aetiology and surgical outcome","volume":"58","author":"Vidarsdottir","year":"2010","journal-title":"Thorac Cardiovasc Surg"},{"key":"2026091312053727500_ref3","doi-asserted-by":"crossref","DOI":"10.1093\/bjs\/znaf260","article-title":"Treatment strategies for Boerhaave syndrome: multinational retrospective cohort study","volume":"112","author":"Hauge","year":"2025","journal-title":"Br J Surg"},{"key":"2026091312053727500_ref4","doi-asserted-by":"crossref","first-page":"1453","DOI":"10.1016\/S0140-6736(07)61602-X","article-title":"The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies","volume":"370","author":"Elm","year":"2007","journal-title":"Lancet"}],"container-title":["Diseases of the Esophagus"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/dote\/article-pdf\/39\/5\/doag100\/71049209\/doag100.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/dote\/article-pdf\/39\/5\/doag100\/71049209\/doag100.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,13]],"date-time":"2026-09-13T16:05:42Z","timestamp":1789315542000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/dote\/article\/doi\/10.1093\/dote\/doag100\/8793143"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,2]]},"references-count":4,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,9,2]]}},"URL":"https:\/\/doi.org\/10.1093\/dote\/doag100","relation":{},"ISSN":["1120-8694","1442-2050"],"issn-type":[{"value":"1120-8694","type":"print"},{"value":"1442-2050","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,10]]},"published":{"date-parts":[[2026,9,2]]},"article-number":"doag100"}}