CTICasesGastric Conduit Leak
Imaging findings
Serial chest radiographs in a patient post-esophagectomy show progressive, marked rightward displacement and bowing of the mediastinal gastric conduit/gastric tube, associated with mediastinal widening. Chest CT confirms a large mediastinal fluid and gas collection (abscess) arising from a leak at the high esophagogastric anastomosis, displacing the conduit to the right.
Key takeaways
Anastomotic leak is a serious complication of esophagectomy with gastric pull-up. While direct visualization of the leak can be difficult on swallow studies if it is medial or posterior, progressive mass effect and displacement of the gastric conduit on chest radiographs is a highly sensitive sign of a contained or uncontained leak and mediastinal abscess collection, requiring urgent CT evaluation.
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