Palacios-Zertuche JT, Montero-Cantú CA, Guerrero-Hernández AJ, Salinas-Domínguez R, Pérez-Rodríguez E, Muñoz-Maldonado GE

Language: Spanish
References: 14
Page: 222-226
PDF size: 239.73 Kb.

ABSTRACT

Background: Penetrating neck injuries represent 5-10% of all trauma lesions that present to the emergency room resulting in significant mortality. Case report: 34-year-old male is brought to the emergency room with a gunshot wound in the neck. Urgent endotracheal intubation was performed and then referred to the operating room. We performed a transverse cervical incision observing both, esophageal and tracheal lesions comprising the third and fourth tracheal rings. A tracheostomy tube was put in place through the anterior tracheal lesion. Debridement of the borders and primary closure of the esophageal lesion was carried out in order to place a vascularized sternothyroid muscle flap between the tracheal and esophageal injuries. A drain is placed and gastrostomy is performed. Enteral nutrition via gastrostomy was indicated for ten days. Oral intake was reinstituted afterwards without evidence of leakage. Conclusion: A vascularized muscle flap, involving the sternocleidomastoid or infrahyoid muscles, is critical to protect the esophageal repair and reduce the incidence of tracheoesophageal fistulas and leakage.

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