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2012, Number 4

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Rev Med MD 2012; 3.4 (4)

Drained tracheosophageal fistula to thorax second to firearm projectile wound. Case report

Preciado-Amador N, Bautista-González S, Guzmán-Chávez OR, Martín del Campo-Madariaga E, Jiménez-Fernandez CA, Ruvalcaba-Castañeda O, López-Taylor JG, González-Luna R, Ruiz-Velazco A

Language: Spanish
References: 12
Page: 226-229
PDF size: 521.38 Kb.


ABSTRACT

A patient who suffered firearm projectile wound with bullet hole on right neck zone II. The surgical exploration showed a 0.3 cm lesion to lateral side of trachea repaired with primary closure. The patient presented systemic inflammatory response syndrome (SIRS), a contrasted study showed tracheoesophageal fistulous tract drained to left pleura, so performing a new surgical exploration that found a 0.5 cm tracheal defect on level with the fourth ring. The fistulous tract was confirmed and corrected with primary closure, as well as the transhiatal esophagectomy with proximal esophagectomy and jejunostomy. Only 5-10 % of the trauma wounds involve cervical lesion, however, when the piercing injuries immediately endanger the patient’s life, presenting a secondary mortality between 1 and 10%. The esophagus is wounded in 5% of the cases with a mortality rate of 15 to 20 %. The tracheoesophageal fistula is a rare complication acquired by trauma wound.


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