Primary repair of esophageal perforation: Case report
| Autor: | Akello W. Abila, Mburu E. Nditika, Stephen Ondigo, Khwa-Otsyula Bo, Rono D. Kipkemoi |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Pleural effusion Fistula medicine.medical_treatment Perforation (oil well) Chest physiotherapy 030230 surgery Article Esophageal injury 03 medical and health sciences Primary repair 0302 clinical medicine Esophageal perforation Case report medicine Thoracotomy Esophagus business.industry medicine.disease Thoracostomy Surgery medicine.anatomical_structure Traumatic injury 030220 oncology & carcinogenesis business |
| Zdroj: | International Journal of Surgery Case Reports |
| ISSN: | 2210-2612 |
| Popis: | Highlights • Most common mechanism of esophageal perforation is iatrogenic. • High index of suspicion in penetrating chest trauma followed by relevant investigations may reduce delay. • Early primary repair is sufficient for select cases of traumatic esophageal perforation. • Associated injuries are more likely in such cases to lead to increased morbidity. Introduction Mortality after esophageal perforation is high irrespective of the treatment modality. The rarity of traumatic esophageal perforations has made it difficult to conduct comprehensive studies that can answer pertinent questions with regard to management. Presentation of case We report a case of through and through thoracic esophageal injury caused by an assailant’s arrow in a young physically active male adult. Diagnosis was made on-table. He successfully underwent primary repair of the esophageal injury 16 h post injury via a left thoracotomy. Recurrent lung collapse and pleural effusion was managed with tube thoracostomy and chest physiotherapy. Discussion Esophageal perforations occur infrequently and may produce vague symptoms leading to diagnostic and therapeutic delays. High index of suspicion particularly in penetrating chest trauma followed by relevant investigations may reduce delay. Principles of management include treatment of contamination, wide local drainage, source control and nutritional support. Source control is achieved surgically or through endoluminal placement of stents. Surgical options include primary repair, creation of a controlled fistula by T-tube or esophageal exclusion. Conclusion Primary repair of traumatic injury to a healthy esophagus is feasible for cases diagnosed early and without significant mediastinal contamination as in our case. Associated injuries are more likely in such cases to lead to increased morbidity and prolonged hospital stay and must be handled carefully. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|