Case Presentation: A 55-year-old man presented to the ED with the complaint of severe chest pain. He reported severe, sharp pain in the left side of the chest, radiating to the back. The pain had started during sexual intercourse, followed by an episode of vomiting. The patient denied diarrhea, cough, fever, or any other trauma. Medical History: The patient had a history significant for HIV without any opportunistic infections, gout, hypertension, and diabetes mellitus.
Social history: He had a habit of smoking 10-pack of cigarettes per year and consuming two alcoholic beverages per week. Laboratory blood workup was within the normal range. Chest radiograph showed left-sided pleural effusion and left-sided pneumothorax. The history of vomiting followed by sharp chest pain was suggestive of esophageal rupture. Pleural fluid amylase and amylase isoenzyme tests confirmed the diagnosis of…
