CTICasesEsophageal Rupture with Intramural Dissection
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Imaging findings
CT demonstrated pneumomediastinum and an intramural dissection component within the esophagus, with gas clearly visible in the muscular layer. An esophagram confirmed an esophageal rupture, showing a subtle leak or tiny hole with contrast tracking within the esophageal wall.
Key takeaways
This case presents a classic scenario of esophageal rupture, likely precipitated by bratwurst impaction and/or subsequent endoscopy, compounded by an intramural dissection. The imaging highlights both pneumomediastinum and the unique appearance of gas tracking within the esophageal wall. The subtlety of the actual leak on esophagram underscores the diagnostic challenge in some cases of esophageal injury.
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