Abstract
A 45-year-old man presented with a left-sided pneumothorax following an episode of forceful vomiting. His chest drain revealed biliary contents and his CT chest with oral contrast confirmed the diagnosis of oesophageal rupture. He was transferred for surgical repair to a tertiary centre. Biliary contents within a chest tube are an important clinical finding and should raise suspicion of Boerhaave's syndrome. Any delays should be avoided due to the high mortality.