To cite: Atie M, Dunn G, Falk GL. BMJ Case Rep Published online: [please include Day Month Year] doi:10.1136/bcr-2016217391 DESCRIPTION A 45-year-old, cognitively impaired, morbidly super obese male patient is described with a delayed presentation of Boerhaave’s syndrome. The patient had been mistakenly treated elsewhere for an empyema of the left thorax. The primary diagnosis had been based on...