CureusFeb 20, 2026

A Rare Case of Esophagus Rupture After Unsupervised Increase of Diabetes Medication Injection

GLP-1 Therapies Weekly Brief ↗PubMed ↗DOI ↗

Updated Feb 21, 2026

Abstract

An 18-year-old woman developed a contained oesophageal perforation following severe vomiting induced by a weight loss medication.

Oesophageal perforation can result from forceful vomiting, often linked to specific medications.
Imaging revealed a pneumothorax and extensive air in the chest area, but no ongoing leakage from the perforation.
The absence of ongoing contrast extravasation suggests that the perforation may have spontaneously sealed.
The patient was managed conservatively with intravenous antibiotics, fluids, and proton pump inhibitors.
Close clinical observation and multidisciplinary monitoring were essential for successful management.

Simplified

Oesophageal perforation, also known as Boerhaave's syndrome, is a rare but potentially fatal condition that classically results from forceful emesis. Prompt diagnosis is critical, as delays are associated with a significant increase in morbidity and mortality. We present the case of an 18-year-old woman who developed severe and persistent vomiting after self-escalation of a dual glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) receptor agonist prescribed for weight loss, culminating in a contained oesophageal perforation. Imaging demonstrated a pneumothorax and extensive mediastinal emphysema (pneumomediastinum), without evidence of ongoing contrast extravasation on water-soluble swallow, suggesting spontaneous sealing of the perforation. The patient was successfully managed conservatively on a medical ward with intravenous (IV) antibiotics, IV fluids, proton pump inhibitor (PPI) therapy, and close clinical observation. This case highlights the importance of recognising severe vomiting associated with GLP-1/GIP receptor agonist therapy as a potential precipitant of oesophageal injury and demonstrates that carefully selected contained perforations may be successfully managed conservatively with close multidisciplinary monitoring.

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Competing interests

Human subjects: Informed consent for treatment and open access publication was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

PubMed

A Rare Case of Esophagus Rupture After Unsupervised Increase of Diabetes Medication Injection

Abstract

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Competing interests

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Abstract

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