Esophageal Disruption From Blunt and Penetrating External Trauma

Spenler, Charles W.

doi:10.1001/archsurg.1976.01360240043007

Cited by 61 publications

(5 citation statements)

References 7 publications

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“…However, on review of published series where mandatory exploration is advocated, there are numerous reports of major injuries which have been missed at exploration with considerable morbidity (3,4, 12, 14, 15,29,30) and mortality (6,9,16). In one series (16) the total mortality of cervical oesophageal lacerations was due to injuries overlooked at exploration.…”

Section: Discussionmentioning

confidence: 99%

“…Deaths due to undetected pneumothorax (6,9) can be prevented by preoperative chest X-rays, though the only death considered avoidable in this series occurred from a misplacement of an intercostal catheter in a patient with a large haemopneumothorax. Endoscopy and contrast swallow are less reliable (16,30) but they may detect injuries missed at emergency surgery. One of our patients had an unnecessarily wide exploration of the mediastinum to locate an old oesophageal injury which had not been previously outlined by water-soluble medium which we normally use.…”

Section: Neurologicalmentioning

confidence: 99%

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Penetrating injuries of the neck: A prospective study of 108 patients

Campbell

Robbs

1980

British Journal of Surgery

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One hundred and eight patients were admitted to King Edward VIII Hospital, Durban, with a penetrating wound of the neck and were managed by a conservative policy. Intervention was undertaken if, and only if, there was an indication of damage to deep structures. Data were collected prospectively. Significant sequelae were seen in only 50 patients (46 per cent) and 26 underwent surgery. Three patients died from their neck injuries (2.8 per cent). 2 after operative intervention and 1 after conservative management. Morbidity was higher after surgery, though local sepsis in wound haematomas was more common in those treated conservatively. A selective policy for surgical intervention is safe and justifiable. A minimum mortality and morbidity can be obtained by adequate preoperative evaluation which includes the use of contrast radiography and angiography.

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Section: Discussionmentioning

confidence: 99%

Section: Neurologicalmentioning

confidence: 99%

Penetrating injuries of the neck: A prospective study of 108 patients

Campbell

Robbs

1980

British Journal of Surgery

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“…Although most of these injuries have been attributed to the anatomical difficulties presented by navigating instruments through the cricopharyngeus, a proportion of them occur in the elderly because of limited neck extension and bony osteophytes juxtaposed to the posterior esophagus, both of which are consequences of cervical osteoarthritis. The non‐iatrogenic perforations are constituted by blunt trauma injuries, 7 hyperextensive neck injuries 8 penetrating trauma, foreign bodies, and tumor. Spontaneous esophageal perforations (Boerhaave syndrome) have traditionally been attributed to violent vomiting producing barotrauma, motility disorders, lower esophageal ring, and food impaction.…”

Section: Discussionmentioning

confidence: 99%

Thoracic osteophyte: rare cause of esophageal perforation

Rathinam

Makarawo

Norton

et al. 2010

Diseases of the Esophagus

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Esophageal perforation is a difficult problem in thoracic surgery. Esophageal perforations can be spontaneous, iatrogenic, or malignant. We report two cases of esophageal perforations caused by thoracic osteophytes and different management strategies leading to successful outcomes. An 80-year-old male presented with chest pain and dysphagia following a fall. On endoscopy, an esophageal perforation and foreign body was noted which was confirmed as a thoracic osteophyte on computed tomography scan. He was managed conservatively as he declined surgery. A 63-year-old male was admitted with dysphagia following a food bolus obstruction. Following esophagoscopy and dilatation, there was clinical and radiological evidence of perforation. During surgery, a thoracic osteophyte was identified as the cause of perforation. The perforation was closed in layers and the osteophyte was trimmed. Both patients recovered well. Thoracic osteophytes are a rare cause of esophageal perforations and a high index of suspicion is required in patients with osteoarthritis who present with esophageal perforations.

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“…7 The exact mechanism of pharyngooesophageal perforation often remains unknown. Iatrogenic complications usually occur acutely and may be caused by sharp retractor blades, 2,4,5 hyper-extension of the cervical spine [8][9][10] or by traumatic intubation. [11][12][13][14][15] Delayed pharyngo-oesophageal complications may be associated with extrusion of the bone graft or with the development of infection.…”

Section: Discussionmentioning

confidence: 99%

Pharyngeal perforation: a late complication of cervical spine surgery

Woolley

Smith

2005

J. Laryngol. Otol.

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Anterior cervical spine fusion and stabilization is a well-recognized procedure for a number of cervical spine disorders. Unfortunately, the complex anatomy of the cervical spine means that these procedures are not without complications. Pharyngo-oesophageal perforation is a rare but potentially life-threatening complication of cervical spine surgery and may present intra-operatively, in the immediate post-operative period or many years later. We present the case of a gentleman with ankylosing spondylitis who presented with a pharyngeal perforation and fistula five years after cervical spine surgery.

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Esophageal Disruption From Blunt and Penetrating External Trauma

Cited by 61 publications

References 7 publications

Penetrating injuries of the neck: A prospective study of 108 patients

Penetrating injuries of the neck: A prospective study of 108 patients

Thoracic osteophyte: rare cause of esophageal perforation

Pharyngeal perforation: a late complication of cervical spine surgery

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