What features on CT are suggestive of injury to the oesophagus?
Pneumomediastinum, mediastinitis, hydropneumothorax and leaking of oral contrast into the mediastinum or pleural space are suggestive of injury to the oesophagus. If the oesophagus is in or close to the wound tract in penetrating injury, oesophageal injury must be presumed even if it is not directly visualised.
What test is the best test for evaluating suspected tracheal or laryngeal injury?
Bronchoscopy. If CT findings are indeterminate as to whether there is tracheobronchial injury or not, then bronchoscopy should be recommended to directly visualise the airway.
Neck
- There is gas in the retropharyngeal, prevertebral and perivisceral space extending inferiorly to base of neck and superior mediastinum anteriorly with scattered locules of gas at the right base of tongue and anterior strap muscles.
- Possible right internal laryngocoele.
- No evidence of surrounding haematoma or contrast extravasation to suggest vascular injury.
- Contour irregularity of the supraglottic larynx with surrounding locules of gas.
- Findings suspicious oesophageal and tracheal injury.