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高处坠落致食管破裂 1 例

Unique case of esophageal rupture after a fall from height.

机构信息

Department of Surgery, Academic Medical Centre, Amsterdam, Netherlands.

出版信息

BMC Emerg Med. 2009 Dec 15;9:24. doi: 10.1186/1471-227X-9-24.

Abstract

BACKGROUND

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.

CASE PRESENTATION

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.

CONCLUSIONS

This case report presents a high cervical esophageal rupture without associated local injuries after a fall from height.

摘要

背景

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。

病例介绍

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。

结论

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b42d/2801469/4314cc3f1d45/1471-227X-9-24-1.jpg

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