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Learning the hard way: when a CT scan misleads your diagnosis.
BMJ Case Rep.
  • Roger Gill, Aga Khan University
  • Fatima Mannan, Aga Khan University
  • Amber Bawa, Aga Khan University
  • Hasnain Zafar, Aga Khan University
Publication Date
5-1-2015
Document Type
Article
Disciplines
Abstract

Abstract

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 traffic 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.

Citation Information
Roger Gill, Fatima Mannan, Amber Bawa and Hasnain Zafar. "Learning the hard way: when a CT scan misleads your diagnosis." BMJ Case Rep. Vol. 15 Iss. 5 (2015) p. 1 - 4
Available at: http://works.bepress.com/hasnain_zafar/30/