CTICasesMediastinal Extension of a Pancreatic Abscess
Imaging findings
CT abdomen and chest show a large, shaggy, fluid-filled peri-pancreatic abscess tracking superiorly along the gastroesophageal junction through the diaphragmatic hiatus into the posterior mediastinum, causing extrinsic compression of the esophagus.
Key takeaways
Pancreatic fluid collections (pseudocysts or abscesses) can track from the retroperitoneum into the chest, most commonly via the esophageal or aortic hiatus into the posterior mediastinum. On imaging, this can be mistaken for a primary esophageal mass or duplication cyst; identifying the continuity below the diaphragm is diagnostic.
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