Pneumatic rupture of the esophagus occurs when gas under pressure is accidentally delivered into the oral cavity. To the 4 cases previously described we add 2 pediatric patients and in both the source of the offending gas was a bottle of carbonated drink. The mild initial symptoms were followed in both by physical and radiographic findings suggesting pharyngoesophageal perforation. Early radiologic findings included free subcutaneous and mediastinal air, followed later by hydropneumothorax and mediastinal widening as well as leak of contrast material on gastrografin swallow. CT findings contributed to patient evaluation and management.