Learning the hard way: When a CT scan misleads your diagnosis

Roger Christopher Gill, Fatima Mannan, Amber Bawa, Hasnain Zafar

Research output: Contribution to journalArticlepeer-review


Oesophageal injury due to blunt trauma is extremely rare, and when it presents it carries a very high mortality. Time is of essence and if not promptly recognised these injuries could have devastating consequences. We report a case emphasising the importance of oesophagoscopy in diagnosing oesophageal injuries. A young man presented to our emergency ward as an unwitnessed road traffi c accident after receiving first aid from a secondary care facility. At presentation, he was haemodynamically stable with decreased power in lower limbs, and with severe neck and back pain. There was high suspicion of spinal injury, which was later evident on clinical and on radiological findings. A CT scan revealed oesophageal injury, indicated by contrast extravasation, which was convincing enough to proceed without endoscopy. Surprisingly, the apparently convincing injury picked up on CT scan marked by contrast extravasation turned out to be an artefact, which led to a negative surgical exploration.

Original languageEnglish
Article number208918
JournalBMJ Case Reports
Publication statusPublished - 15 May 2015


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