Spontaneous rupture of the esophagus should be suspected in any patient developing severe chest pain after vomiting. The diagnosis is substantiated by the presence of subcutaneous emphysema in the suprasternal region on physical examination and of mediastinal air on the plain chest roentgenogram. Further radiological confirmation may be obtained by oral administration of a watersoluble radio-opaque material. Immediate surgical repair of the esophageal tear is mandatory.
"Spontaneous Rupture of the Esophagus: Report of a Successfully Managed Case,"
Henry Ford Hospital Medical Journal
: Vol. 15
Available at: https://scholarlycommons.henryford.com/hfhmedjournal/vol15/iss3/2