Sawada Shigeaki, Kusama Akio, Shimakage Naohiro, Tanabe Tadashi, Okamura Takanao, Uchida Katsuyuki, Tsukada Kazuhiro, Tajima Kenzo
Department of Surgery, Nagaoka Red-Cross Hospital, Nagaoka, Japan.
Surg Today. 2006;36(6):549-53. doi: 10.1007/s00595-006-3199-4.
We report a case of esophageal perforation caused by an explosion, but which was not diagnosed until 3 days after the injury. A 53-year-old worker sustained superficial dermal burns to his trachea, face, neck, and legs during an explosion. The burns were treated conservatively at a local hospital, but he was transferred to our hospital 3 days after the injury, when mediastinal emphysema and bilateral pleural effusion became evident. An esophagogram followed by computed tomography showed an esophageal perforation caused by the blast injury, and we performed an esophagectomy with recontruction of the gastric tube. After the operation, an X-ray showed a foreign body in the lower abdomen, which we found in the upper thoracic esophagus on the day of injury. We surmised that the patient had inadvertently swallowed a foreign body, which had been heated and scattered by the explosion, and it had melted the upper thoracic esophagus.
我们报告一例由爆炸导致的食管穿孔病例，但该病例直到受伤3天后才被诊断出来。一名53岁的工人在一次爆炸中气管、面部、颈部和腿部遭受浅表皮肤烧伤。这些烧伤在当地医院接受了保守治疗，但受伤3天后他被转到了我们医院，此时纵隔气肿和双侧胸腔积液变得明显。食管造影及随后的计算机断层扫描显示爆炸伤导致食管穿孔，我们进行了食管切除术并重建胃管。术后X线显示下腹部有异物，我们在受伤当天发现该异物位于胸段食管上段。我们推测患者无意中吞下了一个异物，该异物因爆炸受热并散开，从而熔化了胸段食管上段。
