CTICasesMediastinal abscess
Imaging findings
Chest radiograph shows a right paratracheal air-fluid level interface. CT chest shows a large, gas-containing mediastinal fluid collection with an enhancing wall that communicates directly with the mid-esophagus at two points, secondary to necrosis of a cervical esophageal squamous cell carcinoma.
Key takeaways
Esophageal malignancies are prone to necrosis and esophageal wall breakdown post-radiation or chemotherapy due to the lack of an outer serosal layer. This can lead to esophagomediastinal or esophagobronchial fistulas and large, contained mediastinal abscesses.
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