Spontaneous oesophageal rupture, typically associated with vomiting (Boerhaave syndrome; Table 75.2) (usually occurs in the left posterolateral wall of the lower third of the oesophagus, with leak into the left pleural cavity).

Blunt trauma to the chest.

Instrumentation of the oesophagus (risk with diagnostic endoscopy very low; risk increased with procedures such as dilatation of stricture or sclerotherapy of varices).

Surgery to the oesophagus or adjacent structures.

Left atrial radiofrequency ablation for atrial fibrillation (causing atrioesophageal fistula)

Ingestion of a corrosive substance.