Image of the Week: A drinking binge leads to a surgical emergency - Clinical Advisor

Image of the Week: A drinking binge leads to a surgical emergency

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A 58-year-old man presents to the emergency department with dyspnea and with severe chest pain that radiates to his shoulder. He has a history of alcoholism and has just finished a 4-day drinking binge. On examination, crepitus is heard on palpation of the chest wall, and his pain worsens as he swallows. A diagnosis of Boerhaave syndrome is suspected, and thoracentesis drains 800 ml of brown liquid. What is the most common site of esophageal perforation? Take the quiz, learn more about this case, and join the conversation on Figure 1.

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