An unusual perforation of the esophagus.

Abstract

To the Editor.— Your readers may find some interest in this account of an unusual case. Report of a Case.— On Dec 23, 1969, a 67-year-old woman became nauseated while travelling by car early in the afternoon, and vomited. She did not consider herself seriously ill and completed the trip. Late in the afternoon nausea recurred, with pain in the left side of the chest radiating to the left shoulder. Upon the patient's arrival in the hospital emergency room, her skin was cool and moist, and blood pressure was 100/70 mm Hg. An electrocardiogram showed deviation of the S-T segments and the initial impression was that she had suffered a myocardial infarction. The patient's condition was considered precarious. On the following morning, the patient's condition seemed improved. The blood pressure had risen. X-ray films of the chest revealed almost complete collapse of the left lung with much air and fluid