Kanlerd Amonpon, Mahawongkajit Prasit, Achavanuntakul Chompoonut, Boonyasatid Piyapong, Auksornchart Karikarn
Trauma and Surgical Critical Care Division, Department of Surgery, Faculty of Medicine, Thammasat University, Pathumthani, Thailand.
Gastrointestinal Surgery Division, Department of Surgery, Faculty of Medicine, Thammasat University, Pathumthani, Thailand.
Trauma Case Rep. 2023 Jan 6;43:100755. doi: 10.1016/j.tcr.2023.100755. eCollection 2023 Feb.
Diagnosis of blunt esophageal injury is currently a challenging issue. Early surgical interventions still play as the mainstay of treatment. There was no consensus about appropriate treatment options. However, it was potential morbidity if delayed management. We report a 33-year-old man with a history of a motorcycle accident who presented with hematemesis and epigastrium pain. He was initially diagnosed with left pneumohemothorax and low-grade gastric injury. The patient developed a high-grade fever with complex left pneumohemothorax 72-h after admission. The diagnostic studies revealed a lower esophageal rupture. He was treated with trans-gastric primary repair and recovered well with no complications. We propose the trans-gastric intraluminal repair is one of the surgical options in a blunt lower esophageal rupture.
钝性食管损伤的诊断目前是一个具有挑战性的问题。早期手术干预仍是主要的治疗手段。对于合适的治疗方案尚无共识。然而，延迟治疗可能会导致发病。我们报告一名33岁男性，有摩托车事故史，出现呕血和上腹部疼痛。他最初被诊断为左血气胸和轻度胃损伤。患者入院72小时后出现高热伴复杂性左血气胸。诊断检查发现食管下段破裂。他接受了经胃一期修复，恢复良好，无并发症。我们认为经胃腔内修复是钝性食管下段破裂的手术选择之一。
