Fig. 2

Traumatic pneumomediastinum. A patient who experienced high-velocity trauma while skiing with subcutaneous emphysema, bilateral pneumothorax, and pneumomediastinum. Note the air within the esophageal wall that subsequently resolved 1 day later, at the level of the supra-aortic vessels (a, b) and below the carina (c, d) (orange arrows). This appearance mimics the presence of an intramural esophageal dissection that mandates the need to exclude an esophageal injury, which was the case here. Repeated bronchoscopy performed due to persistent air leak through the right drainage tube revealed multi-segmental right bronchial fistulae