CTICasesCervical Esophageal Perforation from Ingested Glass Foreign Body
Imaging findings
Chest radiograph demonstrates gas in the soft tissues of the neck and supraclavicular fossa. CT confirms pneumomediastinum and a linear high-attenuation shard in the cervical esophagus, with a straight edge consistent with glass. Esophagography demonstrates a small luminal leak at the level of the foreign body.
Key takeaways
Glass is generally of similar or higher attenuation than soft tissue on CT, making it detectable when not projected over high-density structures such as the spine. In the cervical esophagus, it may be missed on plain radiography due to overlapping spine density. Supraclavicular and cervical soft tissue gas should prompt evaluation for esophageal or pharyngeal perforation, and CT esophagography can localize the level of injury. Glass foreign body ingestion in psychiatric patients requires a high index of suspicion.
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