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Related Experiment Videos

Esophageal perforation: CT findings

C S White1, P A Templeton, S Attar

  • 1Department of Radiology, University of Maryland Medical Center, Baltimore 21201.

AJR. American Journal of Roentgenology
|April 1, 1993
PubMed
Summary

Computed tomography (CT) is crucial for diagnosing esophageal perforation, especially with atypical symptoms. CT findings, particularly extraluminal air, can be the first indication of this life-threatening condition.

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Area of Science:

  • Radiology
  • Gastroenterology
  • Emergency Medicine

Background:

  • Esophageal perforation is a critical condition requiring prompt diagnosis.
  • Typical presentations include vomiting, chest pain, and subcutaneous emphysema, often diagnosed with contrast esophagograms.
  • Atypical presentations necessitate advanced imaging for early detection.

Purpose of the Study:

  • To highlight the importance of recognizing computed tomography (CT) findings in esophageal perforation.
  • To evaluate the utility of CT in diagnosing esophageal perforation, particularly in cases with atypical clinical features.

Main Methods:

  • Retrospective review of CT scans from 12 patients diagnosed with esophageal perforation.
  • Analysis of perforation sites (cervical vs. thoracic) and causes (neoplastic, idiopathic, iatrogenic, traumatic).
  • Identification and documentation of CT abnormalities associated with esophageal perforation.

Main Results:

  • Common CT findings included esophageal thickening (9/12), periesophageal fluid (11/12), extraluminal air (11/12), and pleural effusion (9/12).
  • The perforation site was directly visualized on CT in only two patients.
  • CT findings provided the initial diagnosis in 33% (4/12) of the cases.

Conclusions:

  • CT scans are optimal for defining extraluminal manifestations of esophageal perforation in patients with atypical symptoms.
  • The presence of extraesophageal air on CT is a highly significant finding.
  • CT can serve as the primary diagnostic tool for esophageal perforation when clinical signs are ambiguous.

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