CT of the esophagus in the ER: what you need to know and what you need to remember.

Computed tomography (CT) imaging is a crucial diagnostic tool in the emergency department (ED) for evaluating non-traumatic esophageal conditions. Advanced imaging techniques such as multidetector CT (MDCT) quickly provide detailed 3D images with high spatial resolution, making it ideal for rapid assessment of a variety of esophageal pathologies. This pictorial essay presents 10 illustrative cases to highlight the clinical applications of MDCT and its critical role in diagnosing conditions like perforation, foreign body impaction, inflammatory or infectious esophagitis, achalasia, fistulae, and neoplasms. Optimized CT protocols, such as contrast-enhanced imaging and advanced postprocessing techniques like maximum intensity projection (MIP) images and volumetric rendering technique (VRT), in addition to 3D cinematic rendering, are crucial in improving diagnostic accuracy and enhancing visualization of anatomical structures. The cases presented emphasize the importance of early detection and timely management of esophageal conditions, as small delays can lead to significantly increased morbidity and mortality. Ultimately, a multidisciplinary approach that coordinates clinical, radiological, and pathological evaluations ensures appropriate management and improved patient outcomes in esophageal emergencies.