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Weekly Chest CasesArchive of Old Cases

Case No : 658 Date 2010-06-07

  • Courtesy of Jeong Min Ko, Dae Hee Han, Jung Im Jung, Myeong Im Ahn, Seok Hee Park / Catholic University of Korea, Seoul, St. Mary's Hospital
  • Age/Sex 40 / M
  • Chief ComplaintVomiting followed by acute onset chest pain
  • Figure 1
  • Figure 2
  • Figure 3

Diagnosis With Brief Discussion

Diagnosis
Spontaneous esophageal perforation (Boerhaave’s syndrome)
Radiologic Findings
CHEST PA shows inhomogeneous increased opacity in the medial portion of Lt lower lung field behind the heart. The descending thoracic aorta silhouette is partly obscured by the opacity.
Pneumomediastinum is seen along the Lt side heart and aortic border.
Chest CT shows large retrocardiac mass-like lesion with internal bubbly radiolucency, suggesting leaked stomach contents. Associated Lt pleural effusion is noted. Pneumomediastinum is also present.
The scan just above the GE junction shows suspicious rupture of the posterolateral wall of the esophagus(arrow).
Findings are suggestive of collection of fluid and gas in the left side mediastinum after rupture of the distal esophagus.
Brief Review
See case no. 582
References
Keywords
Esophagus, Trauma,

No. of Applicants : 136

▶ Correct Answer : 118/136,  86.8%
  • - kyungpook national university hospital , Korea (South) jiwon park
  • - Hotel-Dieu Montreal , Canada nicolas gautier
  • - Oita University, Faculty of Medicine , Japan Fumito Okada
  • - SAISEIKAI KURIHASHI HOSPITAL , Japan YASUO OKUBO
  • - Osaka University , Japan Osamu Honda
  • - Song-do Hospital , Korea (South) Ji-young Yun
  • - Inha University Hospital , Korea (South) Ju Won Lee
  • - University of British Columbia , Canada Amr Ajlan
  • - Assam Medical College , India Karunakaran M
  • - Youngdong Hospital , Korea (South) Sang Min Lee
  • - KMC,Manipal , India satish maddukuri
  • - KING KHALID UNIVERSITY HOSPITAL , Saudi Arabia Elbagir Nasser
  • - Shinchon Severance Hospital , Korea (South) Ho-Joon Lee
  • - CHUV , Switzerland ANNE-SOPHIE KNOEPFLI
  • - SMC , Korea (South) Yi Kyung Kim
  • - Kwang Myung Sungae Hospital , Korea (South) Jiyong Rhee
  • - Louisiana State University - Shreveport , United States Carlos Previgliano
  • - Matto Central Hospital , Japan Manabu Akimoto
  • - Department of Diagnostic Radiology, Chonbuk National University Hospital , Korea (South) Eun Jung Choi
  • - CHU NANCY , France, Metropolitan GREGORY LESANNE
  • - Apollo Gleneagles hosp kolkata , India SALIM PARVEZ
  • - Assam Medical college , India samudra borah
  • - Institute of Chest Diseases,Calicut , India sijith raghavan
  • - Radnet Teleradiology , Turkey Murat Ulusoy
  • - Diskapi Yildirim Beyazit Hospital, Ankara , Turkey Meric Tuzun
  • - Doctors Hospital , Bahamas muneesh sharma
  • - Bundang CHA hospital , Korea (South) Jung Jin Young
  • - Servicio de Imagenolog Hospital Clico Universidad de Chile , Chile Mario Zerega
  • - Osaka University , Japan Hiromitsu Sumikawa
  • - CH de la Ce Basque , France Paul ARDILOUZE
  • - Retd. Prof Thoracic Surgery B.J.MEDIDCAL COLLEGE Punr India , India Bankim Amin
  • - Teleradiology solutions , India harish bhambore
  • - Goa Medical College , India Paresh Desai
  • - NDMVP Nashik , India Imran Jindani
  • - IRSA La Rochelle France , France Denis Chabassiere
  • - CHU Nancy , France, Metropolitan Guillaume LUX
  • - Univ. of Miami/Jackson Memorial , United States mantosh rattan
  • - BVMC , India Abhishek Yashod
  • - ottawa , Canada nishard abdeen
  • - Deptt of Radiodiagnosis & Imaging, PGIMER chandigarh , India Ram Galwa
  • - Virgin Mary Burgas , Bulgaria VLADISLAV RUSINOV
  • - Konkuk university hospital , Korea (South) Jeong Geun Yi
  • - SMC , Korea (South) Jihoon Cha
  • - Bundang CHA hospital , Korea (South) Sojung Kim
  • - CHA Bundang hospital , Korea (South) Hyerin Kim
  • - aarthi scans , India abirami mahadevan
  • - Uzunkopru Devlet Hastanesi , Turkey Armagan Sarac
  • - University of Southern California , United States Alison Wilcox
  • - Dong-A university hospital , Korea (South) Sang-yun LEE
  • - All India Institute of Medical Sciences , India Jitesh Ahuja
  • - Hangang sacred heart hospital , Korea (South) You Mie Han
  • - Kuang Tien General Hospital , Taiwan Seaharn Pan
  • - Radiologie Centrale CHU Saint Etienne , France Romain MALEZIEUX
  • - McGill University , Canada Sean Carr
  • - McGill University , Canada Ben Smith
  • - Dong san medical center , Korea (South) Young-eun Bahn
  • - Hospital Sotiria, Athens, Greece , Greece Vasilios Tzilas
  • - CHRU lille , France manuel toledano
  • - Chonnam university hospital , Korea (South) Minyoung Jung
  • - CHU Grenoble , France Fabrice Bing
  • - jobless , France jean-baptiste Noel
  • - kovai medical centre , India k bhaskar
  • - Saga University , Japan Ryoko Egashira
  • - booali , Iran sirwan akhgar
  • - , Korea (South) Hun-cheol lim
  • - Onomichi municipal hospital , Japan Hirofumi Mifune
  • - Fukuyama daiichi Hospital , Japan Mototsugu Saeki
  • - care hospital , India Chary D
  • - Medical insurance organisation , Egypt Mohamed Farouk
  • - Soonchunhyang university hospital, Bucheon , Korea (South) Hyelin Kim
  • - Hospital M de Deus , Brazil Thiago Bento da Silva
  • - Beaulieu clinic Geneva , Switzerland gilles GENIN
  • - clinique de SAVOIE , France, Metropolitan gay-depassier philippe
  • - ROK air force aerospacemedical center , Korea (South) Daekeon Lim
  • - Catholic medical center , Korea (South) HyunA Kim
  • - chp st martin , France Mariotte benoit
  • - G.R. Medical College, Gwalior , India Rajesh Pillai
  • - HOSPITAL SOTIRIA , Greece AIKATERINI DELAVERI
  • - Medical College Chest Hospital,Thrissur,Kerala , India Raveendran TK
  • - McGill University Health Center , Canada Alexandre Semionov
  • - Seoul Veterans Hospital , Korea (South) Hye Sun Hwang
  • - Seoul Nationial University Bundang Hospital , Korea (South) Hee Seok Choi
  • - PingTung Christian Hospital ,China Medical University ,Taiwan,R.O.C. , Taiwan Jun Jun Yeh
  • - newmasan hospital , Korea (South) park ji hoon
  • - IRSA , France jean-luc BIGOT
  • - Ondokuz Mayis University , Turkey Cetin Celenk
  • - Seoul National University Hospital , Korea (South) Hyungjin Kim
  • - NTUH , Taiwan Kuei-pin Chung
  • - JIPMER , India vijay murugesan
  • - CHU BRABOIS , France Sab Ariane
  • - IRSA Rochefort , France Viviane Pages
  • - hospital de clinicas de porto alegre , Brazil ana zanardo
  • - Myongi , Korea (North) soon Moon
  • - Toyama University Hospital, Laboratory of Pathology , Japan TOMONORI TANAKA
  • - institute of thoracic medicine , India siva raja
  • - Yashoda Superspeciality hospital , India Pravin Mahadevappa
  • - CHRU Lille , France guillaume lefebvre
  • - Onomichi municipal hospital , Japan Ryotaro Kishi
  • - Mallinckrodt Institute of Radiology , United States Travis Henry
  • - Vitalife Clinics , Pune , India. , India Rahul Deshmukh
  • - Homs National Hospital , Syria Rami Abou Zalaf
  • - jaslok hospital & research centre mumbai , India JAINENDRA JAIN
  • - Vital Imaging Centre, Mumbai,India , India Ganesh Agrawal
  • - All India Institute of medical sciences , India Justin Moses
  • - NASA SCANS , India RAKESH BHATIA
  • - CH Pau , France Mathieu Cannella
  • - medical , India anup gupta
  • - All India Institute of Medical Sciences , India Ashish Gupta
  • - grmc , , India nitesh agrawal
  • - UZ GASTHUISBERG , Belgium Johan COOLEN
  • - PITTWATER RADIOLOGY , Australia Saurabh Khandelwal
  • - PITTWATER RADIOLOGY , Australia Julie Arora
  • - SoonChunHyang univ. hospital , Korea (South) Kim Jae Hyun
  • - Chonnam university hospital , Korea (South) LEE HYUN
  • - Department of Radiology, Chonnam National University Hospital , Korea (South) Hyungjun Kim
  • - Chonnam National University , Korea (South) se hee Jung
  • - Chonnam national university hospital , Korea (South) Jang-hyeon Song
  • - NOUR EL-ISLAM RADIOLOGY CENTER , Egypt Elsayed Mousa
▶ Correct Answer as Differential Diagnosis : 6/136,  4.4%
  • - kfhu , Saudi Arabia hind alsaif
  • - HIA Legouest , France Alban Gervaise
  • - Hussein Dey Hospital , Algeria adel allal
  • - MD Sai Baba Diagnostic Centre Nashik,Maharashtra, INDIA , India Sushant Bhadane
  • - IRCCS Istituto Oncologico - Bari , Italy Carlo Florio
  • - Hangang Sacred Heart Hospital , Korea (South) Eil Seong Lee
▶ Semi-Correct Answer : 3/136,  2.2%
  • - radiologist, aditya imaging centre , India vivek patel
  • - seoul national university hospital , Korea (South) Ijin Joo
  • - Lilavati Hospital , India Pralhad Prabhudesai
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