CT Oral Contrast and Contemporary Imaging Pathways for Suspected Oesophageal Perforation in the Emergency Department: a Retrospective Observational Study

To evaluate contemporary computed tomography (CT) imaging pathways for Emergency Department (ED) patients with suspected oesophageal perforation or leak, with a particular focus on oral contrast utilisation, radiologic findings and downstream investigations following the index CT examination. We performed a single-centre retrospective observational study of all adult ED patients who underwent CT imaging including the chest for suspected oesophageal perforation or leak between January 2015 and March 2026. Patients were identified through radiology database search. Demographics, clinical indications, oral contrast use, radiologic findings and investigations performed within five days of the index CT were recorded. A total of 107 patients were included, with six (5.6