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Esophageal perforation

Case contributed by Weiling Tan
Diagnosis certain

Presentation

Patient was unable to speak and had a sore throat. Was swallowing a pill and felt that it was stuck in his throat.

Patient Data

Age: 15 years
Gender: Male
x-ray

Extensive pre vertebral soft tissue gas with extension into bony spinal canal. No radiopaque foreign body was detected.

x-ray

There is pneumomediastinum extending along bilateral supraclavicular region in the lower neck.

Case Discussion

In lateral neck radiographs, soft tissue exposure factors 1 (low kVp, high mAs) should be used in order to better demonstrate the soft tissue.

Upon further investigation, this case was given the diagnosis of Boerhaave's syndrome - the spontaneous rupture of the esophagus following excessive straining 2.

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