CTICasesAtrioesophageal Fistula with Hematemesis
Imaging findings
Chest CT shows small locules of gas in the posterior mediastinum adjacent to the left atrium and esophagus. The patient presented with altered mental status and hematemesis two to three months post-catheter ablation.
Key takeaways
The presence of mediastinal gas adjacent to the left atrium following catheter ablation is highly specific for atrioesophageal fistula. Rapid surgical intervention is crucial as patients often present with massive hematemesis or neurological symptoms from air embolism.
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