gastrointestinal disorders
Esophageal Rupture
Diagnosis of Esophageal Rupture
Chest and abdominal x-rays Esophagography Chest and abdominal x-rays showing mediastinal air, pleural effusion, or mediastinal widening suggest the diagnosis. Diagnosis of esophageal rupture is confirmed by esophagography with a water-soluble contrast agent, which avoids potential mediastinal irritation from barium. CT of the thorax detects mediastinal air and fluid but does not localize the perforation well. Endoscopy may miss a small perforation. 