An 81-year-old man presented to the Emergency Department with progressive shortness of breath 6 hours after an episode of forceful vomiting. The patient was normotensive and afebrile but tachycardic. Chest examination revealed decreased breath sounds in the left hemithorax. A plain chest radiograph was obtained (Fig. 1), and a left thoracostomy tube was placed, which drained 2 litres of dark fluid. A subsequent contrast esophagogram was obtained (Fig. 2).
Can you make the diagnosis?
For the answer and discussion see page 306.
Footnotes
Section Editor: Lawrence A. Stein, MD
Submissions to Radiology for the Surgeon, soft-tissue section, should be sent to Dr. Lawrence A. Stein, Department of Radiology, Royal Victoria Hospital, 687 Pine Ave. W, Montreal QC H3A 1A1.