CTICasesIatrogenic Esophageal Rupture Post-Intubation
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Imaging findings
A patient immediately complained of severe chest pain upon waking from anesthesia after mastectomy. A chest X-ray showed mediastinal abnormality and thickening in the paratracheal region. CT revealed mediastinal debris and gas, with a contained rupture of the esophagus identifiable anterior to its lumen, and associated mediastinitis. The site of rupture possibly correlated with a Zenker's diverticulum.
Key takeaways
Iatrogenic esophageal rupture is a recognized complication of instrumentation, such as endotracheal intubation, and can occur immediately after surgery. It typically presents with acute chest pain and findings of mediastinitis (mediastinal gas, debris, thickening). Pre-existing conditions like Zenker's diverticulum may predispose to such rupture. Imaging with contrast confirms the contained rupture.
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