Inlet to Outlet Shadow

The esophagus, aorta and thoracic duct are three structures that traverse from inlet to outlet of the mediastinum. Dilatation of esophagus or aorta can give rise to inlet to outlet shadows. The thoracic duct is never large enough to be visible. 

Inlet to outlet shadow in the mediastinum to the right of the mid-line is due to esophageal dilatation (achalasia cardia in this case) and dissecting aneurysm on the left. 


Inlet to Outlet Shadow

  • Inhomogeneous cardiac density

  • Right sided inlet to outlet shadow

  • Barium swallow: Dilated esophagus

This is a case of achalasia cardia.