CT of the chest demonstrates endotracheal tube, nasogastric tube and right internal jugular central line appropriately positioned.
Extensive pneumomediastinum and subcutaneous emphysema noted. Contained contour irregularity in the distal trachea, just above the carina measures 1 cm transverse x 3.5 cm long, is likely to be the source of the gas.
Small bilateral effusions. No pneumothorax. Minor patchy air space opacity, in keeping with atelectasis. There are multiple small nodules, 4 mm or less in both lungs. Heart and aorta within normal limits on this unenhanced CT.
Distal tracheal contour irregularity. It is difficult to precisely measure the size of the defect, which would be better assessed on bronchoscopy.