Perforation or rupture of the oesophagus is an important differential diagnosis in chest pain. Clinically, pain follows vomiting and a chest radiograph shows left pleural effusion with gas in the mediastinum. There may be distress, dysphagia and dyspnoea.
It should not be confused with Mallory-Weiss tear, which is a tear in the mucosa of the oesophagus, and thus, is managed more conservatively.
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