Which of the following is listed as an 'other' cause of acute mediastinitis?

• A. Boerhaave syndrome
• B. Asthma
• C. Migraine
• D. Alcoholic hepatitis

Answer: (A)

Acute mediastinitis occurs when infection or inflammatory processes involve the mediastinal space, most often after direct contamination from the esophagus or thoracic surgery. Boerhaave syndrome, a spontaneous esophageal rupture after forceful vomiting, directly introduces esophageal and gastric contents into the mediastinum, leading rapidly to mediastinitis. That connection makes it a classic and serious “other” cause.

The other conditions listed do not involve the mediastinal space or esophageal perforation, so they don’t fit as causes of acute mediastinitis. Asthma affects the airways, migraines are neurologic, and alcoholic hepatitis concerns the liver.