1 MCQs in Surgery for NEET PG
A 58-year-old man presents to the emergency department 18 hours after forceful vomiting with severe lower chest pain, dyspnea, and subcutaneous emphysema in the neck and upper chest. CT chest with water-soluble oral contrast reveals **pneumomediastinum** (marked **A** in the diagram) along with mediastinal fluid, left-sided pleural effusion, and esophageal wall thickening. Which of the following is the most appropriate next step in management for this patient?
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