Recurrent pericardial syndromes following Boerhaave's syndrome: a complex clinical presentation and case report.

Background: Recurrent pericardial syndromes secondary to Boerhaave's syndrome (spontaneous oesophageal rupture) are exceedingly rare and represent diagnostic and therapeutic challenges. Case summary: We present a case of a 46-year-old male with recurrent pericardial effusions and cardiac tamponade following Boerhaave's syndrome. Initial management included surgical repair of the oesophageal rupture and medical treatment for the subsequent effusions with colchicine, non-steroidal anti-inflammatory drugs, and corticosteroids. The patient experienced multiple recurrences despite medical therapy, necessitating a multidisciplinary approach. Ultimately, a pericardiectomy was performed, revealing significant pericardial adhesions and inflammation. Post-operative recovery was uneventful with recurrence of effusion. Discussion: This case underscores the importance of early recognition and multidisciplinary management in recurrent pericardial syndromes associated with oesophageal rupture. While first-line medical therapy can be effective, persistent or refractory cases may require surgical intervention. Early surgical consultation should be considered when medical management fails.