Correct!
3. 1 and 2
Both 1 and 2 are correct. The repeat thoracic CT shows fairly symmetric bilateral lung consolidation presumably reflecting aspiration-related acute lung injury. The pneumomediastinum and subcutaneous emphysema have improved significantly. However, there is gross irregularity of the right lateral mid-thoracic trachea, appearing as an outpouching, at the 8 o’clock position, raising the possibility of trachea injury resulting in the pneumomediastinum and subcutaneous emphysema at presentation (Figure 5).
Figure 5. Left: coronal minimum intensity projected image shows the tracheal disruption (arrow) to advantage. Right: Multiplanar image rotating around the long axis of the trachea shows the right posterolateral outpouching.
Based on the data thus far, which of the following represents the next most appropriate step for the evaluation of this patient? (Click on the correct answer to proceed to the eighth and last panel)