Chilimindris C P
J Trauma. 1977 Dec;17(12):968-71. doi: 10.1097/00005373-197712000-00014.
A young man with severe multiple injuries following a motorcycle accident was admitted with head and mandible fractures, coma, fracture dislocation at C5-C6 resulting in total leg paralysis, partial paralysis of the right arm and intercostal muscles, and closed chest injury with possible pulmonary contusion. On the fourth day he developed fulminating mediastinitis and massive empyema, and was found to have a ruptured esophagus. Recovery became possible with surgical drainage of the pleural cavity and mediastinum, proximal and distal decompression of the esophagus, antimicrobial therapy, irrigation of the pleural cavity, complete intravenous hyperalimentation, and infusions of salt-poor albumin. The patient was discharged after 95 days, and 7 months after injury is neurologically intact except for a partial right wrist drop. This rare esophageal rupture should be suspected in any chest injury patients, especially those characterized by extreme cyanosis, dyspnea, shock, and prostration incompatible with thoracic cage injury.
一名因摩托车事故受重伤的年轻男子入院，伴有头部和下颌骨骨折、昏迷、C5 - C6骨折脱位导致双腿完全瘫痪、右臂和肋间肌部分瘫痪，以及闭合性胸部损伤伴可能的肺挫伤。在第四天，他发展为暴发性纵隔炎和大量脓胸，并被发现食管破裂。通过胸腔和纵隔的外科引流、食管近端和远端减压、抗菌治疗、胸腔冲洗、完全静脉高营养以及输注低钠白蛋白，患者得以康复。患者在95天后出院，受伤7个月后，除了右手腕部分下垂外，神经功能完好。对于任何胸部损伤患者，尤其是那些表现为极度发绀、呼吸困难、休克和虚脱且与胸廓损伤不符的患者，都应怀疑这种罕见的食管破裂。
