Department of Surgery, Academic Medical Centre, Amsterdam, Netherlands.
BMC Emerg Med. 2009 Dec 15;9:24. doi: 10.1186/1471-227X-9-24.
Traumatic ruptures of the esophagus are relatively rare. This condition is associated with high morbidity and mortality. Most traumatic ruptures occur after motor vehicle accidents.
We describe a unique case of a 23 year old woman that presented at our trauma resuscitation room after a fall from 8 meters. During physical examination there were no clinical signs of life-threatening injuries. She did however have a massive amount of subcutaneous emphysema of the chest and neck and pneumomediastinum. Flexible laryngoscopy revealed a lesion in the upper esophagus just below the level of the upper esophageal sphincter. Despite preventive administration of intravenous antibiotics and nutrition via a nasogastric tube, the patient developed a cervical abscess, which drained spontaneously. Normal diet was gradually resumed after 2.5 weeks and the patient was discharged in a reasonable condition 3 weeks after the accident.
This case report presents a high cervical esophageal rupture without associated local injuries after a fall from height.
食管创伤性破裂较为罕见,但这种疾病与高发病率和死亡率相关。大多数创伤性破裂发生在机动车事故之后。
我们描述了一个独特的病例,一位 23 岁女性从 8 米高处坠落,随后被送到我们的创伤复苏室。在体格检查中,没有生命威胁性损伤的临床迹象。然而,她有大量的胸颈部皮下气肿和气胸。软性喉镜检查显示食管上段在食管上括约肌以下有一处损伤。尽管预防性给予静脉内抗生素和通过鼻胃管进行营养支持,但患者仍发展为颈脓肿,脓肿自行引流。2.5 周后逐渐恢复正常饮食,3 周后患者在情况尚可的情况下出院。
本病例报告介绍了一例高处坠落伤后发生的高位颈段食管破裂,且无局部损伤。