Presentation
Stab wound to neck and chest.
Patient Data
CT neck and chest show gas in 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. There is also a thin curvilinear lucency posterior to upper intrathoracic esophagus and contour irregularity of the supraglottic larynx with locules of gas.
These findings are suspicious for esophageal and tracheal injury.
CT chest shows several locules of gas anterior to lower sternum with midline soft tissue laceration. High density fluid in the right cardiophrenic angle is consistent with blood extending inferiorly anterior to left lobe of liver. The subtle hypodensities in the subcapsular region of segment 2 is suspicious for a liver laceration.
Case Discussion
The above findings are suspicious for esophageal and tracheal laceration with a possible subcapsular hepatic injury.