MediAI

  Clinical Hook The emergency department was unusually busy when a 28-year-old woman arrived complaining of severe retrosternal chest pain and painful swallowing. The triage team immediately considered pulmonary embolism, acute coronary syndrome, and acute aortic pathology because chest pain in a young adult can occasionally represent a life-threatening emergency. Contrast-enhanced chest CT was therefore performed without delay. Surprisingly, none of the anticipated thoracic emergencies were identified. There was no pulmonary embolism. No aortic catastrophe. No mediastinal hemorrhage. Instead, the radiologist noticed a finding that many physicians might easily overlook during an emergency interpretation. The esophagus appeared diffusely dilated. Within the lumen were multiple pockets of mixed air and soft-tissue attenuation, producing the characteristic appearance of foamy intraluminal debris . The patient had congenital HIV infection, but there was another unexpected finding. She ...