A 40-year-old man with acute chest pain after an alcohol binge.
Imaging Findings
(A, B) Contrast-enhanced computed tomography (CT) of the chest demonstrates pneumomediastinum, with air in the middle mediastinum (arrows, A) and surrounding the distal esophagus at the level of the esophagogastric junction (arrow, B). Bilateral pleural effusions and bilateral basilar parenchymal opacities are also appreciated.
Differential Diagnosis