Correct!
2. Esophageal obstruction
The appearance of the mediastinal gas is consistent with an esophageal location. The rather long cephalocaudad appearance of this lucency suggests distal esophageal obstruction. An intrathoracic stomach with torsion can present with esophageal dilation owing to obstruction, but a globular gas lucency, presenting gas within the obstructed stomach, would also be present. A trachea-esophageal fistula would not necessarily be associated with esophageal dilation, and may be accompanied by infiltrative lung abnormalities owing to the passage of material from the esophagus into the trachea and then into the pulmonary parenchyma. Esophageal diverticula may be seen as focal gas-containing lucencies, but generally not a tubular-shaped, long-segment gas-containing mediastinal structure. Esophageal pneumatosis would manifest as thin, linear streaks of gas tracking through the esophageal wall.
A prior thoracic CT (Figure 4) from 2 years earlier, performed in an emergency room for shortness of breath and suspected pulmonary embolism, was located.
Figure 4. Upper left A-I: Axial enhanced thoracic CT displayed in soft tissue windows obtained as part of acute pulmonary embolism evaluation for shortness of. Upper right A-I: lung windows. Lower panel: video of thoracic CT in soft tissue windows.
Which of the following is the most appropriate consideration for the findings on this thoracic CT scan? (click on the correct answer to be directed to the seventh of eleven pages)