PMC4900107_01
77-year-old man with esophageal rupture. Portable chest radiograph shows subtle retrocardiac opacity (arrow) and blunted left costophrenic angle (arrowhead) consistent with mild pleural fluid and overlying consolidation.
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Portable chest radiography revealed a mild, left-lower-lobe consolidation (Fig. 1).
77-year-old man with esophageal rupture. CT of the abdomen and pelvis with oral and intravenous contrast. Axial (A) CT image at the level of the aortic arch shows a dilated, air-and-fluid-filled thoracic esophagus (arrow). Axial (B) and coronal (C) CT images show extraluminal contrast and air (large arrows) extending to the left of the distal esophagus (e). Also note associated bilateral pleural fluid (B, pf) and overlying left-lung base atelectasis (B, arrowheads).
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This study showed a normal aorta but distension of the thoracic esophagus with residual contrast material, indicating possible partial obstruction (Fig. 2). At the esophagogastric junction there was extravasation of contrast into an adjacent complex collection of fluid and air, which drained into the left pleural space, consistent with distal esophagus perforation (Figs. 2A-C).