CT of the chest demontrastes ETT, NGT and Right central line appropriately positioned.
Extensive pneumomediastinum and subcutaneous emphysema noted. Contained contour irregularity in the distal trachea, just above the carina measures 1cm TV x 3.5cm 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 nodule, 4mm and 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.