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Majeski J et al. – The only clinical feature demonstrated by the patient was neck crepitation after completion of the EGD. Initial evaluation of the referred patient by posterior and lateral chest x–rays revealed extensive pneumomediastinum with subcutaneous emphysema. A unique chest computed tomography scan demonstrated suspension of the esophageal mucosal surface and lumen in a “bull's eye” configuration. A water–soluble esophageal swallow followed by a thin liquid barium swallow demonstrated that the esophageal perforation had sealed.

   

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