Cervical esophageal rupture after blunt trauma resulting from a car accident

Abstract

Traumatic perforation of the cervical esophagus due to blunt trauma is a very rare condition which continues to be associated with significant mortality rates. The symptoms and signs of this injury are often masked by or ascribed to more common blunt thoracic injuries. This paper presents a case of cervical esophageal perforation secondary to blunt trauma resulting from a car accident. The injury was diagnosed early by computed tomography examination, and the patient underwent prompt and successful surgical repair performed to prevent the development of descending mediastinitis.

Oesophageal perforation – therapeutic and diagnostics challenge. Retrospective, single-center case report analysis (2009–2015)

“…Due to its possible occurrence within three different anatomical compartments, it is characterized by a diversity of symptoms, most of them being being highly unspecific, which significantly elongates delays the time between perforation and final diagnosis followed by institution ofand appropriate targeted management. Despite the markedly improvedmarked improvement in diagnostic methods as well as inand medical care being provided in intensive care units the medical care provided in intensive care units, esophageal perforation remains to beis still associated with a high mortality rate of 5-40%, orand, if the disease is diagnosed with a delay ofthe diagnosis is delayed by more than 24 h, the mortality rate is as high as 50% [1,2,3]. Due to the diversity of potential mechanisms leading to perforation, non-specificity of clinical symptoms, and variety of therapeutic procedures, no uniform guidelines have been established to date with regard to the management of patients with this condition.…”

Late presentation of esophageal rupture following blunt thoracic trauma

“…2,3 The management and prognosis depend on the site and extent of injury, time of presentation, and degree of contamination. Although food particles in the intercostal drain raise a strong suspicion, esophageal rupture can be confirmed by computed tomography, 4 Gastrografin esophagogram, 5 or flexible esophagoscopy. 6 An aggressive management strategy with diversion and decontamination coupled with early institution of enteral feeding are essential.…”

Blunt Traumatic Esophageal Injury: Decreased Mortality With Urgent Repair

“…In the event of a negative esophagography and CT with suspicion of esophageal injury, an endoscopy can be performed. 2 Although this diagnostic modality is a great alternative on stable patients, it can cause an iatrogenic injury in another location of the esophagus. Additionally, an endoscopy is contraindicated in patients with cervical injury wearing neck braces, which is often present in poly-trauma patients presenting with esophageal injury.…”