CTICasesDescending Inflammatory Mediastinitis from Pharyngeal Perforation
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Imaging findings
Initial neck CT shows air and fluid in the right pharynx, communicating with the pharynx, and a small foreign body (possibly a fishbone or triticeal cartilage). Subsequent chest CT shows effacement of mediastinal fat by edema fluid, which extends outwards into the peribronchial connective tissue sheaths. Later follow-up reveals more inflammation, and new pericardial fluid.
Key takeaways
Pharyngeal perforation can lead to descending inflammatory mediastinitis, characterized by extensive mediastinal edema and inflammation, which can track along the axial connective tissue compartment into the lungs. Purulent pericardial effusion is a known, severe complication of such infections tracking from the neck into the mediastinum.
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