Close
Arterial phase with oral contrast (misprotocoled - should have been without IV contrast).
Once again the extensive pneumomediastinum is noted. Bilateral pleural effusions and consolidation is noted.
There is hold-up of oral contrast within the oesophagus. There is a large amount of contrast in the posterior mediastinum surrounding and a small amount of contrast noted extending into the left pleural cavity. A discrete point of leak is suspected posteriorly just superior to the hiatus hernia.
The upper abdominal contents are unremarkable.
Conclusion
Boerhaave syndrome with contrast extravasation into the posterior mediastinum and left hemithorax.