Boerhaave syndrome

A 45-year-old woman begins complaining of chest pain in the post-anesthesia care unit after undergoing an upper endoscopy for evaluation of esophageal varices. She states the pain radiates to the back. She also complains of dyspnea, nausea, and she has produced blood-tinged vomitus. Past medical history is notable for chronic alcohol use disorder and liver cirrhosis. Her temperature is 37.5°C (99.5°F), blood pressure is 107/61 mmHg, and pulse is 82/min. Physical examination shows a woman in acute distress. Crackles are heard while auscultating over the heart. Abdominal exam is notable for hepatosplenomegaly. CT imaging reveals the following:  



Reproduced from: Radiopedia  

Which of the following is the most likely cause of this patient’s presentation?