Esophageal injuries in the setting of trauma are rare, with an incidence of .001 % in the setting of blunt chest trauma. The duration of time from injury to repair is the main factor that influences the high mortality and morbidity rates of esophageal injury secondary to blunt trauma. This paper presents a case of esophageal injury secondary to blunt trauma resulting from a 25 foot fall. The patient presented three hours after the injury with esophageal perforation noted on CT scan. The patient then underwent prompt surgical repair. It is of paramount importance for investigators to maintain a high index of suspicion for esophageal perforation in poly-trauma patients presenting with blunt chest injury as a missed diagnosis can lead to worse outcomes and limited repair options for patients.
This study presents a formal text analysis of trauma surgery textbooks. We examine passages that describe disparities or mechanisms of injury, and we report types of underlying causes and preventative interventions discussed. Trauma textbooks were drawn from an industry-standard list used by medical libraries. Chi-square testing was used to determine whether different types of underlying causes or preventative interventions were discussed by disparity type (those affecting racial minorities vs rural populations) and injury mechanism (accidental injuries vs intentional interpersonal injury). 146 passages were extracted from 7 textbooks, totaling 5576 pages of text. Passages discussing rural disadvantages or unintentional injury were substantially more likely to describe structural risk factors or governmental interventions than those discussing racial disadvantages or intentional injury, respectively. Textbook authors should consider enriching discussion of violence prevention or racial disparities to emphasize structural causes and interventions.
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