Fig. 12
From: Chest CT examinations in patients presenting with acute chest pain: a pictorial review
A 25-year-old male presented at the ED with complaints of chest pain, radiating to the shoulders. The pain started during evening dinner with an impacted food bolus. His history revealed dysphagia. At the ED he acutely developed dyspnoea after drinking water. Subcutaneous emphysema developed. A routine chest X-ray and thoracic CT examination were performed for further evaluation. (a) The coronal thoracic CT shows intramural gas extending from the level of the upper oesophagus to the (b) stomach (arrow) accompanied with extensive pneumopericardium, pneumomediastinum, and subcutaneous emphysema, due to perforated oesophageal dissection. At endoscopy, two foci of perforation in the distal oesophagus were found, which were successfully treated by placement of a (retrievable) covered stent