'Bubbles and esophagus: A tale of unexpected and otherwise unexplained pain'

Boerhaave's syndrome is a potentially fatal emergency, typically induced by forceful retching, which leads to increased intra-esophageal pressure. It commonly presents with vague symptoms such as chest pain or more classic symptoms like subcutaneous emphysema and vomiting. We present an unusual case of Boerhaave syndrome secondary to rapid and excessive intake of carbonated drinks in a 22-year-old male, who presented to our emergency department with atypical symptoms of fever and shortness of breath. Imaging studies showed left-sided hydropneumothorax with an esophageal pleural fistula, and multidisciplinary teams were involved in the patient's management.