Learning Radiology xray montage

Retropharyngeal Air
Perforated Pharynx


  • Causes
    • Trauma to esophagus or trachea
      • Penetrating injuries from weapons
      • Perforation from within
        • Chicken bone
    • Mediastinal emphysema which tracks up into neck
    • Retropharyngeal abscess from gas-forming organism
  • Clinical findings
    • Dysphagia
    • Odynophagia
    • Neck tenderness
    • Crepitus
    • Hematemesis
  • Imaging findings
    • Streaks of air in the soft tissues of the neck
    • Anterior displacement of the pharynx
    • Associated pneumothorax possible
    • Cervical or mediastinal air is seen in 60% of cases of ruptured esophagus
  • Treatment
    • If hemodynamically stable, watch
    • If hemodynamically unstable, emergent surgery

 perforated pharynx

Perforated Pharynx. Streaky lucencies seen behind the airway represents
retropharyngeal air which in this case was secondary to
perforation of the cervical esophagus by a chicken bone.