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Pneumothorax Rupturing into Hernia Sac

Imaging findings

Patient with chronic pneumothorax and prior esophagectomy developed pneumomediastinum and pneumoperitoneum. CT confirmed the pneumothorax tracked along the mediastinum and ruptured into a hernia sac containing colon.

Key takeaways

Chronic air leaks can decompress into adjacent hernia sacs; not all pneumoperitoneum necessitates immediate concern for visceral perforation if the source is identified.

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