This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Surgery
Boerhove's syndrome, true about 
Select and explain. 
A. Iatrogenic, B. Silent manifestation, C. Presented with acute chest pain, D. Treatment is conservative
C: Presented with acute chest pain
Answer: C: Presented with acute chest pain 
Explanation: Occurs classically when a person vomits against a closed glottis. The pressure in the oesophagus increases rapidly, and the oesophagus usually bursts in the lower third, sending a stream of material into the mediastinum and often the pleural cavity as well.
Presents with acute chest pain
Operative repair is the mainstay in large perforations,
Non-operative repair can be used in small perforations, with minimal septic load esp in case of perforations during flexible endoscopy.