What is typically seen on a chest X-ray (CXR) in a case of Boerhaave's syndrome?

In a case of Boerhaave's syndrome, which is a rupture of the esophagus leading to the leakage of esophageal contents into the mediastinum, the most common finding on a chest X-ray is typically a pleural effusion. This effusion may occur due to the irritation of the pleura by the spillage of gastric contents, leading to an inflammatory response.

When esophageal rupture occurs, it can result in mediastinitis and subsequent pleural effusion, often on the left side due to the anatomical location of the esophagus and the pattern of leakage. The effusion may appear as an area of increased opacity on the chest X-ray, indicating fluid accumulation in the pleural space.

While pneumothorax or consolidation could be associated with other types of chest trauma or lung infections, they are not characteristic findings of Boerhaave's syndrome. Free air under the diaphragm can be seen in cases of perforated abdominal viscera but is less commonly associated with esophageal rupture. Therefore, the presence of a pleural effusion is the most indicative radiological finding in Boerhaave's syndrome on a chest X-ray.