Mackler’s Triad

Mackler triad refers to the classic presentation of Boerhaave syndrome.

Boerhaave’s syndrome is also known as spontaneous esophageal rupture or effort rupture of the esophagus.  Although vomiting is thought to be the most common cause, other causes include weightlifting, defecation, epileptic seizures, abdominal trauma, compressed air injury, and childbirth, all of which can increase the pressure in the esophagus and cause a barogenic esophageal rupture.

Mackler’s triad comprises of vomiting, pain and subcutaneous emphysema seen with esophageal rupture.

In only 50% cases, does Boerhaave syndrome present with Mackler’s triad, of
(1) vomiting followed by (2) chest pain and (3) subcutaneous emphysema due to an eesophageal rupture.

The classic presentation of spontaneous esophageal rupture is that of a middle-aged man with a history of dietary overindulgence and overconsumption of alcohol who experiences chest pain and subcutaneous emphysema after recent vomiting or retching (Mackler triad). The classic Mackler triad is present in approximately 50% of cases.

Another triad in esophageal rupture is Andersen triad.


Leave a Comment

Your email address will not be published. Required fields are marked *