Traumatic esophageal perforation in Puerto Rico Trauma Hospital: A case-series

Vázquez-Rodríguez, Jan C.; Toro, Natalia M. Pelet del; García-Rodríguez, Omar; Ramos-Meléndez, Ediel O; López-Maldonado, Julio; Rodríguez, Felipe; Mejías, Jorge Pelet; Rodríguez-Ortiz, Pablo

doi:10.1016/j.amsu.2019.06.011

Cited by 5 publications

(3 citation statements)

References 34 publications

(66 reference statements)

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“…It has been reported that 90% of neck stab wounds involve the shallow cervical region, which is shallower than the vast lateral, sternocleidomastoid, and anterior cervical muscle groups, and that deep neck injuries are rare [ 6 ]. Previous reports suggest that esophageal injuries, especially those involving the thoracic esophagus rather than the cervical esophagus, have a high mortality rate [ 1 , 7 ]. Therefore, esophageal injuries should not be overlooked.…”

Section: Discussionmentioning

confidence: 99%

Thoracic esophageal injury due to a neck stab wound: a case report

et al. 2021

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Background Traumatic esophageal injury leads to severe complications such as mediastinitis, pyothorax, and tracheoesophageal fistula. Although prompt diagnosis and treatment are required, there are no established protocols to guide diagnosis or treatment. In particular, thoracic esophageal injury tends to be diagnosed later than cervical esophageal injury because it has few specific symptoms. We report a case of thoracic esophageal injury caused by a cervical stab wound; the patient was stabbed with a sharp blade. Case presentation A 74-year-old woman was attacked with a knife while sleeping at home. The patient was taken to the emergency room with an injury localized to the left section of her neck. She was suspected of a left jugular vein and recurrent laryngeal nerve injury from cervical hematoma and hoarseness. On the day following the injury, computed tomography revealed a thoracic esophageal injury. Emergency surgery was performed for an esophageal perforation and mediastinal abscesses. Although delayed diagnosis resulted in suture failure, the patient was able to resume oral intake of food a month later following enteral feeding with a gastrostomy. Esophageal injuries due to sharp trauma are rare, and most are cervical esophageal injuries. There are very few reports on thoracic esophageal injuries. Conclusions The possibility of thoracic esophageal injury should always be considered when dealing with neck stab wounds, particularly those caused by an attack.

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Section: Discussionmentioning

confidence: 99%

Thoracic esophageal injury due to a neck stab wound: a case report

et al. 2021

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“…The most common causes of full thickness esophageal injury are spontaneous perforation and iatrogenic injury, while non-iatrogenic blunt and penetrating trauma to the esophagus is a relatively rare occurrence ( 4 , 5 ). Among all trauma patients, the incidence those who have of traumatic injuries to the esophagus is low from <1% to 10% ( 3 , 6 - 8 ).…”

Section: Incidence Of Non-iatrogenic Esophageal Traumamentioning

confidence: 99%

“…All of these reasons lead to esophageal trauma having a high morbidity and mortality ( 3 ). Non-iatrogenic blunt and penetrating trauma to the esophagus are a relatively rare occurrence, compared to iatrogenic trauma ( 4 ). The workup and management of non-iatrogenic trauma continues to evolve, with new innovative approaches available for both diagnosis and treatment.…”

Section: Introduction: Anatomy Of the Esophagusmentioning

confidence: 99%

Non-iatrogenic esophageal trauma: a narrative review

Schraufnagel¹,

Mubashir²,

Raymond³

2022

Mediastinum

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Background and Objective Non-iatrogenic esophageal trauma is a rare entity that has a high morbidity and mortality. The diagnosis can often be quite challenging, however is critical to perform in a timely manner. The workup and management of non-iatrogenic trauma continues to evolve, with new innovative approaches available for both diagnosis and treatment. The aim of this narrative review is to comprehensively describe the incidence, presentation, workup, treatment approaches and outcomes of non-iatrogenic esophageal trauma. Methods A thorough literature review was performed using full length articles available in English via PubMed between January 1, 1960 to September 30, 2021, focusing on the epidemiology, workup and treatment of non-iatrogenic esophageal trauma, including current surgical techniques. Key Content and Findings Injuries to the cervical esophagus are more common than injuries to the thoracic esophagus, occurring more in young males, with significant racial disparity. Penetrating trauma via gunshot wounds are the most common forms of injury, followed by stab wounds and blunt trauma. Workup is multimodal and involves a combination of plain radiographs, computed tomography (CT) scans, endoscopy and fluoroscopy depending of the stability of the patient and associated injuries. Conclusions Workup and management of non-iatrogenic esophageal trauma depends on the location and extent of esophageal injury, and can include observation, debridement and drainage, esophageal diversion, endoscopic approaches or esophagectomy, with indications, techniques and outcomes described in further detail in this review.

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Current aspects in the management of esophageal trauma: a systematic review and proportional meta-analysis

Papaconstantinou,

Kapetanakis,

Mylonakis

et al. 2024

Diseases of the Esophagus

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Summary Trauma-related esophageal injuries (TEIs) are a rare but highly lethal condition. The presentation of TEIs is very diverse depending on the location and mechanism of injury (blunt vs. penetrating), as well as the presence or absence of concurrent injuries. The aim of the present systematic review and meta-analysis is to delineate the clinical features impacting TEI management. A systematic review of the Medline, Embase, and web of science databases was undertaken for studies reporting on patients with TEIs. A random effects model was employed in the meta-analysis of aggregated data. Eleven studies, incorporating 4605 patients, were included, with a pooled mortality rate of 19% (95% confidence interval (CI) 13–25%). Penetrating injuries were 34% more likely to occur (RR 0.66, 95% CI 0.49–0.89, P = 0.01), predominantly in the neck compartment. Surgery was employed in 53% of cases (95% CI 32–73%), with 68% of patients having associated injuries (95% CI 43–94%). In terms of choice of surgical repair technique, primary suture repair was most frequently reported, irrespective of injury location. Postoperative drainage was employed in 27% of the cases and was more common following repair of thoracic esophageal injuries. The estimated dependence on mechanical ventilation was 5.91 days (95% CI 5.1–6.72 days), while the length of stay in the intensive care unit averaged 7.89 days (95% CI 7.14–8.65 days). TEIs are uncommon injuries in trauma patients, associated with considerable mortality and morbidity. Open suture repair of ensuing esophageal defects is by large the most employed approach, while stenting may be indicated in carefully selected cases.

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Traumatic esophageal perforation in Puerto Rico Trauma Hospital: A case-series

Cited by 5 publications

References 34 publications

Thoracic esophageal injury due to a neck stab wound: a case report

Thoracic esophageal injury due to a neck stab wound: a case report

Non-iatrogenic esophageal trauma: a narrative review

Current aspects in the management of esophageal trauma: a systematic review and proportional meta-analysis

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