Mezuki Satomi, Shono Yuji, Akahoshi Tomohiko, Hisanaga Kana, Saeki Hiroshi, Nakashima Yuichiro, Momii Kenta, Maki Jun, Tokuda Kentaro, Maehara Yoshihiko
Emergency and Critical Care Center, Kyushu University Hospital, Fukuoka, Japan.
Emergency and Critical Care Center, Kyushu University Hospital, Fukuoka, Japan.
Am J Emerg Med. 2017 Nov;35(11):1790.e3-1790.e5. doi: 10.1016/j.ajem.2017.08.043. Epub 2017 Aug 19.
Esophageal perforation due to blunt trauma is a rare clinical condition, and the diagnosis is often difficult because patients have few specific symptoms. Delayed diagnosis may result in a fatal clinical course due to mediastinitis and subsequent sepsis. In this article, we describe a 26-year-old man with esophageal perforation due to blunt chest trauma resulting from a motor vehicle accident. Because a severe disturbance of consciousness masked the patient's trauma-induced thoracic symptoms, we required 11h to diagnose the esophageal perforation. Therefore, the patient developed septic shock due to mediastinitis. However, his subsequent clinical course was good because of prompt combined therapy involving surgical repair and medical treatment after the diagnosis.
钝性创伤所致食管穿孔是一种罕见的临床病症，由于患者特异性症状较少，诊断往往困难。延迟诊断可能因纵隔炎及随后的脓毒症导致致命的临床病程。在本文中，我们描述了一名26岁男性，因机动车事故导致钝性胸部创伤而发生食管穿孔。由于严重意识障碍掩盖了患者创伤所致的胸部症状，我们花了11小时才诊断出食管穿孔。因此，患者因纵隔炎发展为感染性休克。然而，由于诊断后及时采取了手术修复和药物治疗相结合的疗法，其随后的临床病程良好。
