PMC5420036_01
Chest computed tomography images showing free air within the posterior pericardium.
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Computed tomography (CT) of the chest was obtained, which showed evidence concerning for pneumopericardium and pericardial effusion (Figure 1); this prompted transfer to our facility for a higher level of care.
Intraoperative picture showing direct visualization of the esophagus through gross tear in the posterior pericardium (yellow dotted outline).
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Once the patient was supported on bypass, the heart was lifted up and there was a gross obvious tear noted in the posterior pericardium, which was adjacent to a 2.5-cm tear in the esophagus (Figure 2).
Esophagram images showing small, contained esophageal leak from the left lateral distal esophagus.
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An esophagram for confirmation of healing was completed 1 week after the procedure and, unfortunately, showed evidence of a small, contained esophageal leak (Figure 3).