Fig. 1

First episode. To the left, a computed tomography-scan of our patient depicting a transverse section of the lower thorax with an esophageal perforation in the native setting and the resultant free extraesophageal extravasation of oral contrast, extensive mediastinal emphysema, and inflammation (a), as well as large bilateral pleural effusions (b), suggesting that pleurae on both sides have been compromised. To the right, a schematic figure of a distal intrathoracic esophageal rupture in the native setting with free mediastinal contamination and bilateral rupture of the overlying pleurae, resulting in extensive pleural effusions