[Barotraumatic rupture of the thoracic esophagus in children. Apropos of a case].

Presenting symptoms in an 8-year-old child, subjected to high pressure in the upper respiratory and digestive tracts following bursting of a truck inner tube, were initially only pleuropulmonary in nature. A secondary diagnosis of rupture of the thoracic esophagus was established by radiological follow-through examination using a water soluble medium. The presence of an esophagopleural fistula led to repair of the esophageal tear on the 5th day. Operation involved wide mediastinal and thoracic drainage, protection of the esophageal suture by a minimal pharyngostomy, and the performance of an evacuation gastrostomy and an alimentation jejunostomy. Bipolar esophageal exclusion can be avoided by the use of this technique. When confronted with closed thoracic injuries due to high pressures exerted on the upper respiratory and digestive tracts, radiological examination of the esophagus employing water-soluble media should be conducted, therefore, to enable early diagnosis of any esophageal rupture. Furthermore, from the therapeutic point of view, even after secondary discovery of an esophageal tear, suturing is not contraindicated by the direct approach as long as protection is provided by minimal pharyngostomy and a gastrostomy, this avoiding the need for bipolar exclusion.