Mediastinal fluid as a predictor for esophageal perforation as the cause of pneumomediastinum

ConclusionThe presence of mediastinal fluid, specifically within the visceral compartment, strongly suggests esophageal injury, and its absence strongly argues against it. An important caveat is in the setting of recent surgery, in which mediastinal fluid can be seen normally. An esophagography study can supplement the evaluation if there is a discrepancy between the clinical suspicion and the original CT findings.
Source: Emergency Radiology - Category: Emergency Medicine Source Type: research