Penetrating Wounds of the Esophagus

Factors affecting outcome in penetrating oesophageal trauma

“…Few published series have focused exclusively on non‐iatrogenic penetrating trauma to the oesophagus2, 3, 5, 13–15, 17, 19, 21, 28 and most recent studies have involved small numbers of patients over a lengthy period. In several studies, often involving patients with oesophageal perforation from a variety of different causes, time has been proposed as an important contributory factor to outcome1–5, 11–14, 17, 20–26. As selective conservative management of penetrating neck injuries is becoming more widely accepted, the time from injury to management is necessarily delayed because of the preoperative investigations undertaken.…”

“…Between one and nine new patients with non‐iatrogenic penetrating oesophageal injuries present to level I trauma centres each year1–17. This low frequency is attributed to the relatively small surface area of the oesophagus, the proximity of vital vascular structures and a relatively protected environment1, 3, 12, 18, 19.…”

“…This low frequency is attributed to the relatively small surface area of the oesophagus, the proximity of vital vascular structures and a relatively protected environment1, 3, 12, 18, 19. Delay in management has often been cited as an important factor contributing to the high rates of morbidity and mortality associated with oesophageal injury1–5, 11–14, 17, 20–26. The majority of these studies included patients with oesophageal perforation associated with pre‐existing oesophageal disease, and combined blunt and penetrating trauma.…”

Trauma to the esophagus

“…This is very uncommon with only a few cases reported. The presence of foreign bodies such as bullet or knife fragments in the projection of the esophagus or distally in the gastrointestinal tract should prompt investigation for esophageal injury using water-soluble contrast material [61] (Fig. perforation described above.…”

“…The diagnosis of esophageal injury may be overlooked, however, due to the presence of associated injury [60]. The injuries most commonly occur in the cervical esophagus from wounds in the lower part of the neck [4,61]. The injuries most commonly occur in the cervical esophagus from wounds in the lower part of the neck [4,61].…”