Ribet M, Pruvot F R
J Chir (Paris). 1986 Mar;123(3):164-8.
Oesophageal barotraumatism is a rare lesion and only 19 cases have been reported in the literature. Four new cases are described, the mechanism involved being either a jet of gas into the oesophagus or an explosion close to the face producing rupture of the oesophagus by increased endoluminal pressure. Four characteristic clinical signs are noted: wounds or burns to the face or mouth, chest or epigastric pain, subcutaneous emphysema and respiratory distress. A pneumomediastinum or pleural effusion is a constant finding, and a perforation is identified regularly by an oesophageal water soluble opacification. Of the 19 cases reported in the literature, 4 were detected at autopsy, one patient died after surgery and 14 recovered after operation. The mediastinal infection was either subacute requiring external thoracic drainage after oesophageal exclusion, or acute, necessitating emergency direct oesophageal repair. Only one of the 4 patients reported in this paper survived the accident.
食管气压伤是一种罕见的病变，文献中仅报道过19例。本文描述了4例新病例，其发病机制要么是气体喷射入食管，要么是面部附近爆炸，通过增加腔内压力导致食管破裂。注意到四个特征性临床体征：面部或口腔伤口或烧伤、胸部或上腹部疼痛、皮下气肿和呼吸窘迫。纵隔气肿或胸腔积液是常见表现，通过食管水溶性造影剂可定期发现穿孔。文献报道的19例中，4例在尸检时发现，1例患者术后死亡，14例术后康复。纵隔感染要么是亚急性的，在食管排除后需要进行胸外引流，要么是急性的，需要紧急直接进行食管修复。本文报道的4例患者中只有1例在事故中幸存。
