Perforation of the esophagus remains a diagnostic and therapeutic challenge. Currently, the most common cause of perforation is instrumentation of the esophagus, but other conditions such as foreign body, trauma, or spontaneous rupture are possible entities in the clinical practice. Multidetector computed tomography has become the imaging technique of choice in the evaluation of this setting of patients because of its capability to depict all the different signs associated with the degrees of wall impairment. By being aware of the appearance of the various entities that affect the esophagus, the radiologist can play an important role in detecting and staging esophageal injuries.
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