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To the Editor:—
As one of the early reporters of a case of spontaneous rupture of the esophagus (Spontanruptur des Oesophagus, Med Klin29:810, 1933), I would like to add a remark to Levine and Kelley's paper in the Jan 25 issue of The Journal (191:343-345). I pointed out that the diagnosis of rupture of the esophagus can be made by testing the aspirated pleural fluid for hydrochloric acid because there is no other condition —with the possible exception of a perforated ulcer in a diaphragmatic hernia—where hydrochloric acid is found in the pleural fluid.
Popper HL. Test for Esophageal Rupture. JAMA. 1965;192(2):173-174. doi:10.1001/jama.1965.03080150103039