Dagestani Hatoon, Alomar Sahar, Alfraidy Doaa, Twier Khaled I, Alramahi Ghassan
Department of Surgery, King Saud University Medical City, Riyadh, SAU.
Department of Trauma Surgery, King Saud University Medical City, Riyadh, SAU.
Cureus. 2024 Feb 6;16(2):e53718. doi: 10.7759/cureus.53718. eCollection 2024 Feb.
Esophageal perforation from blunt trauma is rare. It is more frequently encountered in a penetrative mechanism where the cervical esophagus is most commonly injured. Blunt esophageal injury is challenging to diagnose with nonspecific findings clinically and radiologically within trauma settings. The main factors contributing to difficulty in early recognition are its scarce occurrence combined with nonspecific manifestations clinically on patient examination and radiologically on usual trauma computed tomography with intravenous contrast. We report a case of a 15-year-old young man who sustained an isolated distal blowout esophageal perforation as a result of blunt thoraco-abdominal trauma. Despite early primary surgical repair, a leak developed later on, which was managed with stent placement. The leak and associated sepsis were resolved, with an overall status improvement and no subsequent complications. We report an unusual presentation of esophageal perforation from blunt trauma, which was promptly diagnosed and managed with multiple modalities. This case highlights the importance of early recognition and management of esophageal injury and, furthermore, the role of multiple diagnostic and therapeutic modalities that lead to a successful outcome.
钝性创伤导致的食管穿孔很少见。它更常发生于穿透性机制,其中颈段食管最常受伤。钝性食管损伤在创伤环境中临床和放射学表现不具特异性,诊断具有挑战性。早期识别困难的主要因素是其发生率低,加上患者临床检查和常规静脉注射造影剂的创伤计算机断层扫描的放射学表现均不具特异性。我们报告一例15岁青年男性,因钝性胸腹创伤导致孤立性远端爆裂性食管穿孔。尽管早期进行了一期手术修复,但后来出现了渗漏,通过放置支架进行处理。渗漏和相关的脓毒症得到解决,整体状况改善,且无后续并发症。我们报告了一例钝性创伤导致食管穿孔的不寻常表现,通过多种方式迅速诊断并进行了处理。该病例强调了早期识别和处理食管损伤的重要性,此外还凸显了多种诊断和治疗方式对取得成功结果所起的作用。