<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 23-year-old man presents to the emergency department with bloody vomitus. The patient is an alcoholic and has presented similarly before. He is given ondansetron; however, he continues to vomit. The patient complains of sudden substernal chest pain and dysphagia after another bout of vomiting. His temperature is 99F 37.2C, blood pressure is 11760 mmHg, pulse is 122min, respirations are 15min, and oxygen saturation is 99 on room air. Physical exam is notable for an uncomfortable man with subcutaneous emphysema in the patients neck and supraclavicular areas. Which of the following is the most likely diagnosis?? A: Esophageal rupture, B: Esophageal varices, C: Mallory Weiss syndrome, D: Spontaneous pneumothorax, E: Tension pneumothorax,  <response>: Based on the information provided in the question stem, the key findings are:- 23-year-old alcoholic man with history of bloody vomitus - Presented with bloody vomitus again, given ondansetron but continued to vomit- Developed sudden chest pain and dysphagia after another bout of vomiting - Vital signs notable for tachycardia - Physical exam showed subcutaneous emphysema in neck and supraclavicular areasThe history of alcoholism and bloody vomitus points towards a possible diagnosis of esophageal varices. However, the development of chest pain, dysphagia and subcutaneous emphysema after vomiting suggests esophageal rupture. Of the choices given, esophageal rupture best fits the clinical presentation described.A: Esophageal rupture 