GI imaging: oesophageal perforation: practice question

A Radiology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

Try it

Radiology · GI imaging: oesophageal perforation

Sample item

After violent vomiting, a man has severe chest pain and subcutaneous emphysema. A chest film shows left pleural effusion and mediastinal air. Which investigation confirms the suspected Boerhaave syndrome and shows the site?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Water-soluble contrast swallow followed by CT with oral contrast

Spontaneous rupture of the distal left oesophagus is confirmed by a water-soluble contrast study or CT with oral contrast, which shows extravasation. Water-soluble contrast is used first because barium in the mediastinum causes severe inflammation.

Option by option

  • A. Water-soluble contrast swallow followed by CT with oral contrast (correct)

    Correct. Water-soluble contrast and CT show the leak.

  • B. Bronchoscopy

    Bronchoscopy evaluates the airway and not the oesophageal tear.

  • C. Barium swallow only

    Barium is avoided as the first agent in suspected perforation.

  • D. Chest ultrasound

    Ultrasound does not image the mediastinum.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More Radiology questions

Questions about this Radiology question

What is the answer to this Radiology question?

The best answer is A, Water-soluble contrast swallow followed by CT with oral contrast. Spontaneous rupture of the distal left oesophagus is confirmed by a water-soluble contrast study or CT with oral contrast, which shows extravasation.

Why is "Bronchoscopy" not the answer?

Bronchoscopy evaluates the airway and not the oesophageal tear.

Why is "Barium swallow only" not the answer?

Barium is avoided as the first agent in suspected perforation.

Why is "Chest ultrasound" not the answer?

Ultrasound does not image the mediastinum.

What concept does this question test?

It tests GI imaging: oesophageal perforation in Radiology. Water-soluble contrast is used first because barium in the mediastinum causes severe inflammation.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study GI imaging: oesophageal perforation?

Learn signs with the image, and the disease they point to. Then use the flashcards and the other Radiology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.