This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: All India exam, Subject name: Surgery
[{'content': '85A middle aged man complains A upper abdominal pain after a heavy meal There is tenderness in the upper abdomen and on X ray widening of the mediastinum is seen with pneumo mediastinum what is the diagnosis? \nSelect and explain. \nA. spontaneous perforation of the esophagus, B. Perforated peptic ulcer, C. Foriegn body in esophagus, D. Rupture of emphysematous bulla', 'role': 'user'}, {'content': 'Answer: A \nExplanation: Spontaneous peroforation of esophagus Boerhaave&;s syndrome patient can present with retching subcutaneous emphysema can pain On X rays pneuma mediastinum can be seen ref : bailey and love 27th ed.', 'role': 'assistant'}]