Oesophageal perforation

Case contributed by RMH Core Conditions

Presentation

Pain post eating.

Patient Data

Age: 50
Gender: Male
CT

Pneumomediastinum, with paraoesophageal/posterior mediastinal gas tracking superiorly around the infrahyoid strap muscles. Small bilateral pleural effusions, marginally larger on the left, with associated medial bibasal collapse.

An obliquely orientated, 2.1cm long X 0.4cm wide, curvilinear hyperdensity previously seen within the superior mediastinal oesophagus, anteriorly adjacent to T1/2.

Within the imaged upper abdomen, a small fluid-density collection is seen around to gallbladder and hepatorenal pouch, however, there is no evidence of gallbladder wall thickening or gallstone identified. A very small fluid density collection is noted within the right anterior perirenal space. Upper abdominal organs are of unremarkable appearance.

Conclusion:

  1. Pneumomediastinum, reduced/redistributed since the previous examination.
  2. 2.1cm curvilinear hyperdensity may represent a foreign body. 

Case Discussion

Culprit turned out to be swallowed chop bone. 

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Case information

rID: 29520
Case created: 31st May 2014
Last edited: 10th Sep 2015
Tag: rng
Inclusion in quiz mode: Included

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