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2005, Number 1

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Cir Gen 2005; 27 (1)

Esophageal injuries due to external trauma

Soto-Villagrán RJ, Soto SS

Language: Spanish
References: 31
Page: 57-63
PDF size: 68.56 Kb.


ABSTRACT

Purpose:To perform a bibliographic review on external traumatism of the esophagus.
Data collection:Review of data bases in English (MEDLINE and MD Consult) and in Spanish (Imbiomed and Medigraphics).
Selection of studies:Complete text articles starting in 1994, focusing on esophageal injuries caused by external trauma. We gathered 28 articles in English and 1 in Spanish. Besides, two text books and two statistical tables were consulted.
Data extraction:Bibliographic review on surgical anatomy, epidemiology, classification, physiopathology, diagnosis, treatment, complications, and prognosis.
Results from data synthesis:Lesions due to external trauma of the esophagus are rare entities, although potentially fatal. They can go unnoticed due to the low suspicion index of their presence and the priority given to associated injuries. It is important to discard its presence, either through clinical, surgical or cabinet studies and to implement an early treatment to avoid late complications and an increase in morbidity and mortality. Treatment is getting more selective regarding which patients must be observed, assessed more carefully, or surgically intervened.
Conclusion:Despite its low frequency, an esophageal injury is potentially fatal, therefore in case of suspicion, the diagnosis must be confirmed or discarded, and treatment must be started promptly. Usefulness of esophagoscopy and tomography has not been elucidated yet. It is necessary to assess better the alternatives to primary closure: conservative handling, esophageal shunts, drainages, and prostheses.


REFERENCES

  1. Asensio JA, Berne J, Demetriades D, Murray J, Gómez H, Falabella A, et al. Penetrating esophageal injuries: time interval of safety for preoperative evaluation – how long is safe? J Trauma 1997; 43: 319-24.

  2. Demetriades D, Asensio JA, Velmahos G, Thal E. Complex problems in penetrating neck trauma. Surg Clin North Am 1996; 76: 661-83.

  3. Meredith JW, Riley RD. Injury to the esophagus, trachea, and bronchus. In: Mattox KL, Feliciano DV, Moore EE. Trauma. 4th Ed. Philadelphia: McGraw-Hill. International; 2000: 507.

  4. Ghahremani GG. Esophageal trauma. Semin Roentgenol 1994; 29: 387-400.

  5. Chiu WC, Rodríguez A, Greif WM, Joseph-Herbert JH, Gammaitoni CJ. Entrapment and obstruction of the esophagus from thoracic spine hyperextension-dislocation injury. J Trauma 1999; 46: 959-61.

  6. Instituto Nacional de Estadística Geografía e Informática (INEGI). Estadísticas de mortalidad. Porcentaje de defunciones generales por sexo y principales causas, 1990-2002. Disponible en: URL: http://www.inegi.gob.mx/est/contenidos/espanol/tematicos/mediano/med.asp?t=mpob45&c=3222

  7. Instituto Nacional de Estadística Geografía e Informática (INEGI). Bol Inf Estadística 2002; 11(21). Daños a la salud, 2001. Porcentaje de causas de morbilidad hospitalaria por entidad federativa y principales causas según sexo, 2001 y 2002. Disponible en: URL: http://www.inegi.gob.mx/est/contenidos/espanol/tematicos/mediano/med.asp?t:msal05&c=5645&Î=01

  8. Yugueros P, Sarmiento JM, García AF, Ferrada R. Conservative management of penetrating hypopharyngeal wounds. J Trauma 1996; 40: 267-9.

  9. Asensio JA, Chahwan S, Forno W, MacKersie R, Wall M, Lake J, et al. Penetrating esophageal injuries: multicenter study of the American Association for the Surgery of Trauma. J Trauma 2001; 50: 289-96.

  10. Stanley RB Jr, Armstrong WB, Fetterman BL, Shindo ML. Management of external penetrating injuries into the hypopharyngeal-cervical esophageal tunnel. J Trauma 1997; 42: 675-9.

  11. Flowers JL, Graham SM, Ugarte MA, Sartor WM, Rodríguez A, Gens DR, et al. Flexible endoscopy for the diagnosis of esophageal trauma. J Trauma 1996; 40: 261-5; discussion 265-6.

  12. Flores J, Ortiz PJ, Cervantes J. Trauma penetrante del cuello: ¿Es confiable la exploración física para el diagnóstico de lesiones? An Med Asoc Med Hosp ABC 2000; 45: 6-12.

  13. Weiman DS, Pate JW, Walker WA, Brosnan KM, Fabian TC. Combined gunshot injuries of the trachea and esophagus. World J Surg 1996; 20: 1096-9; discussion 1099-100.

  14. Richardson JD, Miller FB, Carrillo EH, Spain DA. Complex thoracic injuries. Surg Clin North Am 1996; 76: 725-48.

  15. Cordero JA, Kuehler DH, Fortune JB. Distal esophageal rupture after external blunt trauma: report of two cases. J Trauma 1997; 42: 321-2.

  16. Weiman DS, Walker WA, Brosnan KM, Pate JW, Fabian TC. Noniatrogenic esophageal trauma. Ann Thorac Surg 1995; 59: 845-9; discussion 849-50.

  17. Polsky S, Kerstein MD. Pharyngo-esophageal perforation due to blunt trauma. Am Surg 1995; 61: 994-6.

  18. Monzon JR, Ryan B. Thoracic esophageal perforation secondary to blunt trauma. J Trauma 2000; 49: 1129-31.

  19. Ojima H, Kuwano H, Sasaki S, Fujisawa T, Ishibashi Y. Successful late management of spontaneous esophageal rupture using T-tube mediastinoabdominal drainage. Am J Surg 2001; 182: 192-6.

  20. Swann LA, Munter DW. Esophageal emergencies. Emerg Med Clin North Am 1996; 14: 557-70.

  21. Hanpeter DE, Demetriades D, Asensio JA, Berne TV, Velmahos G, Murray J. Helical computed tomographic scan in the evaluation of mediastinal gunshot wounds. J Trauma 2000; 49: 689-94; discussion 694-5.

  22. Richardson JD, Tobin GR. Closure of esophageal defects with muscle flaps. Arch Surg 1994; 129: 541-7; discussion 547-8.

  23. American College of Surgeons Committee on Trauma: Advanced Trauma Life Support Course. Chicago, American College of Surgeons, 1997: 21-42.

  24. Degiannis E, Benn CA, Leandros E, Goosen J, Boffard K, Saadia R. Transmediastinal gunshot injuries. Surgery 2000; 128: 54-8.

  25. Losken A, Rozycki GS, Feliciano DV. The use of the sternocleidomastoid muscle flap in combined injuries to the esophagus and carotid artery or trachea. J Trauma 2000; 49: 815-7.

  26. Renz BM, Cava RA, Feliciano DV, Rozycki GS. Transmediastinal gunshot wounds: a prospective study. J Trauma 2000; 48: 416-21; discussion 421-2.

  27. Kotsis L, Kostic S, Zubovitsz K. Multimodality treatment of esophageal disruptions. Chest 1997; 112: 1304-9.

  28. Victorino GP, Porter JM, Henderson VJ. Use of a gastric pull-up for delayed esophageal reconstruction in a patient with combined traumatic injuries of the trachea and esophagus. J Trauma 2000; 49: 563-4.

  29. Mason GR. Esophageal perforations, anastomotic leaks, and strictures: the role of prostheses. Am J Surg 2001; 181: 195-7.

  30. Nana AM, Stefanidis C, Chami JP, Deviere J, Barvais L, De Smet JM. Esophageal perforation by echoprobe during cardiac surgery: treatment by endoscopic stenting. Ann Thorac Surg 2003; 75: 1955-7.

  31. Port JL, Kent MS, Korst RJ, Bacchetta M, Altorki NK. Thoracic esophageal perforations: a decade of experience. Ann Thorac Surg 2003; 75: 1071-4.




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