CTICasesRuptured Substernal Colonic Interposition Conduit in VACTERL Association
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Imaging findings
Chest radiography and CT demonstrate a substernal, gas-filled, sacculated conduit containing colonic haustra, with associated free air in the surrounding mediastinum indicative of a pneumomediastinum. An upper GI barium study highlights the corkscrew appearance of the colonic interposition conduit and localized leakage of contrast from a focal rupture.
Key takeaways
Colonic interposition is a surgical reconstruction technique used to replace the esophagus in patients with severe esophageal atresia (often in the setting of congenital syndromes like VACTERL association) or caustic injuries. Leakage or localized perforation of the conduit can lead to pneumomediastinum and mediastinitis, requiring prompt diagnosis through contrast-enhanced imaging or fluoroscopic barium swallow to guide management.
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