Symptoms:

The main symptom is pain at first.

Patients with a perforation in the middle portion or lowermost portion of the esophagus may have difficulty swallowing, chest pain, and difficulty breathing.

Signs and tests:

Signs include:

• Fast breathing
• Fever
• Low blood pressure
• Rapid heart rate

Patients with a perforation in the top part of the esophagus may have neck pain or stiffness and air bubbles underneath the skin.

A chest x-ray may reveal air in the soft tissues of the chest, fluid that has leaked from the esophagus into the space around the lungs, or a lung collapse.

A chest CT scan may show an abscess in the chest or esophageal cancer. X-rays taken after you drink a non-harmful dye can help pinpoint the location of the perforation.