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What is A middle aged man complains of upper abdominal pain after a heavy meal. There is tenderness in the upper abdomen and on X-ray, widening of the mediastinum is seen with pneumo-mediastinum. What is the diagnosis? and explain in detail?
Above clinical scenario is suggestive of diagnosis of spontaneous perforation of the esophagus. Aka BOERHAAVE Syndrome - Caused by Forceful vomiting Repeated vomiting - Clinical features - Characterized byMackler's triad Thoracic Pain Vomiting Cervical subcutaneous emphysema Investigation - On CXR - Hydropneumothorax - IOC for Dx - Water soluble contrast esophagogram (Gastrograffin > Hypaque)