Figure 1.

Axial slices, computed axial tomography of the chest at the level of the upper-lung fields (formatted to lung windows). Extra-pulmonary air is seen tracking along the right (white arrow) and posterior aspects of the trachea.

Figure 2.

Axial slices, computed axial tomography of the chest at the level of the mid-lung fields (formatted to lung windows). Extra-pulmonary air is seen tracking along the bronchiolar tree (white arrow).

Figure 3.

Axial slices, computed axial tomography of the abdomen in the upper-abdomen (formatted to mediastinal windows). A large amount of intra-abdominal free fluid around the liver, spleen, and peritoneal cavity.

Figure 4.

Sagittal slices, computed axial tomography of the chest and abdomen (formatted to lung windows). Posterior pneumomediastinum and pneumoperitoneum extending along the esophagus and stomach walls (black arrow).

Figure 5.

Coronal slices, computed axial tomography of the chest and abdomen (formatted to mediastinal windows). A large amount of complex intra-abdominal free fluid is demonstrated throughout the abdomen and pelvis, with thickened small bowel concerning for shock bowel.