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Pneumomediastinum Without Pneumothorax Caused by Esophageal Rupture

F. M. Lomoschitz1,2, K. F. Linnau1 and F. A. Mann1

1 Department of Radiology, University of Washington School of Medicine, Harborview Medical Center, Box 359728, 325 Ninth Ave., Seattle, WA 98104-2499.
2 Present address: Department of Radiology, University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria.



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  		Fig. 1A. —Distal esophageal rupture after blunt injury in 58-year-old woman with history of left pneumonectomy. Anteroposterior chest radiograph shows pneumomediastinum (arrowheads) and supradiaphragmal gas extension into left-sided pneumonectomy cavity (arrows).

 


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  		Fig. 1B. —Distal esophageal rupture after blunt injury in 58-year-old woman with history of left pneumonectomy. Enhanced helical CT scan shows paraesophageal pneumomediastinum (white arrow) and thickened esophageal wall (black arrow). Also note splenic injury with adjacent hematoma.

 


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  		Fig. 1C. —Distal esophageal rupture after blunt injury in 58-year-old woman with history of left pneumonectomy. Single-contrast esophagram obtained by injection of 40 cc of water-soluble nonionic contrast material through nasogastric tube shows contrast extravasation (arrows) at left-sided rupture of distal esophagus.

 

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