- Etiology: placement of a nasogastric tube, forceful vomiting or retching (Boerhaave syndrome), blunt trauma against closed glottis or AP compression of the chest
- CXR: pneumomediastinum, pneumopericardium, pneumothorax, hydropneumothorax, subcutaneous emphysema, mediastinitis
- Note: a nasogastric tube that is too straight after placement and that does not gently curve into the stomach should be suspected of not being in the stomach
- UGI: contrast outside of esophagus
- Complications: mediastinitis
- Treatment: often conservative
- Clinical: can be devastating if not recognized
Radiology Cases of Esophageal Perforation
Radiology Cases of Esophageal Perforation Due to Nasogastric Tube
![CXR of esophageal perforation from nasogastric tube placement](https://pediatricimaging.org/wp-content/uploads/2020/07/nasogastrictubemalfunction02mdhematemesistraumaticnasogastrictubeplacementpresumedesophagealperforationesophagramnegativepneumothoraxpneumoediastinumpneumopericardiumaspirationpneumoniac.jpg?w=1024)
![AXR of esophageal perforation from nasogastric tube placement](https://pediatricimaging.org/wp-content/uploads/2020/07/nasogastrictubemalfunction05mdesophagealperforationnasogastrictubetoostraightnotinstomachonusilealperforationaxrsupxtable1do.jpg?w=1024)
Radiology Cases of Esophageal Perforation Due to Blunt Trauma
![CT and UGI of esophageal perforation](https://pediatricimaging.org/wp-content/uploads/2023/06/traumaesophagealperforation01mdhitthroatonrimofplasticchairthroatpainhemoptysispneumodiastinumc4esophagealperforation5yo.jpg?w=1024)