Esophageal pneumatosis: a pictorial review

Gastrointestinal pneumatosis has been reported from the esophagus to the rectum, with most cases involving the small bowel, stomach, or colon. Esophageal pneumatosis is rare, with only a small number of case reports described in the literature, although it is likely underreported. Esophageal pneumatosis may be idiopathic or secondary to a specific underlying cause. Mechanisms of esophageal pneumatosis include increased intraluminal pressure, mucosal disruption, and dissection of air from an extraesophageal source. Depending on the underlying cause, esophageal pneumatosis is usually benign although it may be indicative of a life threatening condition. Esophageal pneumatosis is typically detected with CT, although it may be evident during direct visualization with endoscopy. In this article, we review the etiologies and imaging appearances of esophageal pneumatosis.