Presentation
Pain post gastroscopy.
Patient Data
There is extensive posterior mediastinal gas surrounding the esophagus and tracking to the visceral space of the neck. The esophageal wall is indistinct, particularly in the midthoracic esophagus, where there is a cuff of surrounding high attenuation material suggestive of hematoma. Similar mixed fluid attenuation material is seen throughout the length of the esophagus.
The findings are compatible with esophageal perforation post gastroscopy although a site of perforation is not demonstrated on these images, particularly in the absence of oral contrast.
A moderate hiatus hernia is also incidentally noted.
There is no pneumothorax or pleural effusion. Negligible lingular and bibasal atelectasis. Otherwise the lungs are clear. No suspicious osseous lesions identified.
Calcifications in the region of the pancreas may be vascular as opposed to intrapancreatic.
Bilateral breast prostheses in situ.
Conclusion:
Perforated esophagus post-gastroscopy.
Case Discussion
Esophageal perforation post gastroscopy is uncommon but is a known complication.