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case_images: (A) Axial section of the head CT without contrast showing an approximately 1.5-cm mass in the left frontal lobe with surrounding vasogenic edema (white arrow), (B) MRI T1, (C) MRI T2, and (D) MRI DWI showing a ring-enhancing lesion within the left frontal lobe with surrounding vasogenic edema (white arrow).. Abbreviations: CT, computed tomography; DWI, diffusion-weighted imaging; MRI, magnetic resonance imaging.
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case_images: A head computed tomography (CT) scan showed multiple intracranial masses with surrounding vasogenic edema (Figure 1). Magnetic resonance imaging (MRI) of the brain revealed multiple ring-enhancing lesions within the left temporal lobe, left frontal lobe, and left insula concerning for malignancy or abscesses (Figure 1).
case_images: Axial section of the abdominal and pelvic CT showing distal esophageal thickening (white arrow).. Abbreviation: CT, computed tomography.
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case_images: The CT scan revealed an esophageal thickening; therefore, gastrointestinal evaluation was recommended as an outpatient (Figure 2).
case_images: Axial section of the chest CT angiogram showing a gas collection around the esophagus (white arrow).. Abbreviation: CT, computed tomography.
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case_images: Due to his prior incidental CTA finding that raised suspicion of pulmonary embolism, a CTA was performed which revealed a gas collection around the esophagus (Figure 3).
case_images: Axial section of the CT esophagram obtained after administration of oral contrast material showing an esophageal leak (white arrow) with a small amount of mediastinal gas (yellow arrow).. Abbreviation: CT, computed tomography.
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case_images: A CT esophagography with oral contrast was done and showed an esophageal leak (Figure 4).
case_images: (A) EGD showing a 2-mm perforation at 28 cm from the incisors (yellow arrow). (B) EGD showing a fistula status after de-epithelialization with argon plasma coagulation (yellow arrow). (C) Post-clipping EGD showing successful closure of esophageal perforation.. Abbreviation: EGD, esophagogastroduodenoscopy.
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case_images: The patient underwent urgent esophagogastroduodenoscopy (EGD), which revealed a 2-mm perforation of unknown etiology in the middle third of the esophagus, located at 28 cm from the incisors (Figure 5). De-epithelialization of the fistula tract and orifice, along with tissue destruction using argon plasma, was successfully performed (Figure 5). Closure was achieved using an Over-The-Scope Clipping Device (OVESCO), which was deployed successfully over the fistula orifice (Figure 5).
case_images: Axial section of the chest CT showing an esophageal clip (white arrow) without any esophageal leak.. Abbreviation: CT, computed tomography.
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case_images: One-month follow-up brain MRI showed complete resolution of the abscess, and the follow-up chest CT scan showed no persistent esophageal leak (Figure 6).