Oesophageal perforation

Case contributed by RMH Core Conditions

Presentation

Pain post gastroscopy.

Patient Data

Age: 67
Gender: Female
Modality: CT

There is extensive posterior mediastinal gas surrounding the oesophagus and tracking to the visceral space of the neck. The oesophageal wall is indistinct, particularly in the midthoracic oesophagus, where there is a cuff of surrounding high attenuation material suggestive of haematoma. Similar mixed fluid attenuation material is seen throughout the length of the oesophagus.

The findings are compatible with oesophageal 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 oesophagus post-gastroscopy.

Case Discussion

Oesophageal perforation post gastroscopy is uncommon but is a known complication. 

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Case Information

rID: 34210
Case created: 9th Feb 2015
Last edited: 9th Oct 2015
Inclusion in quiz mode: Included

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