Images in Cardiothoracic Medicine and Surgery Asian Cardiovascular & Thoracic Annals 2015, Vol. 23(4) 492 ß The Author(s) 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav DOI: 10.1177/0218492313517516 aan.sagepub.com
Pneumopericardium and pneumomediastinum after esophageal bolus impaction Asghar Ali1,2, Andrea Tordini1 and Ion S Jovin1,2
Figure 1. (A) Chest radiograph and (B) computed tomography showing pneumopericardium (arrows) and pneumomediastinum (arrowheads).
A 74-year old-man presented with difficulty swallowing for one day after eating a pork chop. The patient had neck pain. Chest radiography showed pneumopericardium, pneumomediastinum, and subcutaneous emphysema of the neck (Figure 1A). Urgent esophagogastroduodenoscopy showed a large bolus of food obstructing the distal esophagus and a superficial laceration of the distal esophagus. In the interim, the patient vomited out the food bolus. A computed tomography scan of the chest demonstrated air along the pericardium, trachea, lesser curvature of the stomach, and cervical prevertebral soft tissue, with small bilateral pleural effusions (Figure 1B). The patient remained afebrile with stable vital signs and no crepitations in
the neck or chest. He was managed conservatively with intravenous fluids, intravenous antibiotics, and close observation. He was discharged home after 3 days, and was doing well when seen as an outpatient 3 months later. Funding This research received no specific grant from any funding agency in the public, commerical, or not-for-profit sectors.
Conflict of interest statement None declared.
1 Department of Medicine, Virginia Commonwealth University, Richmond, VA, USA 2 Hunter Holmes McGuire Veterans Affairs Medical Center, Richmond, VA, USA
Corresponding author: Asghar Ali, MD, Department of Internal Medicine, McGuire VA Medical Center, Virginia Commonwealth University, 1201 Broad Rock Boulevard, Richmond, VA 23249, USA. Email: [email protected]
Downloaded from aan.sagepub.com at University of Birmingham on November 14, 2015
Pneumopericardium and pneumomediastinum after esophageal bolus impaction Asghar Ali1,2, Andrea Tordini1 and Ion S Jovin1,2
Figure 1. (A) Chest radiograph and (B) computed tomography showing pneumopericardium (arrows) and pneumomediastinum (arrowheads).
A 74-year old-man presented with difficulty swallowing for one day after eating a pork chop. The patient had neck pain. Chest radiography showed pneumopericardium, pneumomediastinum, and subcutaneous emphysema of the neck (Figure 1A). Urgent esophagogastroduodenoscopy showed a large bolus of food obstructing the distal esophagus and a superficial laceration of the distal esophagus. In the interim, the patient vomited out the food bolus. A computed tomography scan of the chest demonstrated air along the pericardium, trachea, lesser curvature of the stomach, and cervical prevertebral soft tissue, with small bilateral pleural effusions (Figure 1B). The patient remained afebrile with stable vital signs and no crepitations in
the neck or chest. He was managed conservatively with intravenous fluids, intravenous antibiotics, and close observation. He was discharged home after 3 days, and was doing well when seen as an outpatient 3 months later. Funding This research received no specific grant from any funding agency in the public, commerical, or not-for-profit sectors.
Conflict of interest statement None declared.
1 Department of Medicine, Virginia Commonwealth University, Richmond, VA, USA 2 Hunter Holmes McGuire Veterans Affairs Medical Center, Richmond, VA, USA
Corresponding author: Asghar Ali, MD, Department of Internal Medicine, McGuire VA Medical Center, Virginia Commonwealth University, 1201 Broad Rock Boulevard, Richmond, VA 23249, USA. Email: [email protected]
Downloaded from aan.sagepub.com at University of Birmingham on November 14, 2015
