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An incomplete esophageal perforation masquerading as variceal bleeding.
What is new in this Letter to the Editor: This case and image emphasizes the importance of considering incomplete esophageal rupture in all patients who present with nausea, as well as in those patients who have hematemesis, as they are at high risk to progress to a complete rupture. We would like to emphasize that this presentation of Boerhaave's is unique in the sense that the patient denied any vomiting, and initially, neither had physical exam findings of pneumo-mediastinum nor any evidence of perforation, but on endoscopy was noted to have essentially an incomplete perforation, and the picture is an excellent representation of an incomplete perforation, and clearly shows the muscle fibers.
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