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Resolution

Diagnosis: Tension pneumothorax.

A follow-up contrast-enhanced computed tomography scan (Figure 2) revealed a ruptured esophagus (Boerhaave’s Syndrome).

Acknowledgement: Case presented by Sian C. Hughes, MBBCh, and Elmari Janssen, MB ChB. Dr. Hughes is a Trust Grade Doctor in Intensive Care Medicine, Department of Critical Care Medicine and Anesthesia, Cheltenham District General Hospital, Cheltenham, England and Dr. Janssen is a Staff Grade Physician in Emergency Medicine at the University Hospital of Wales, Cardiff.

Clinical Challenge: April, 2012
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