Management of Blunt and Penetrating External Esophageal Trauma

Milton S. Glatterer, Richard S. Toon, Cheryl Ellestad, Arthur S. McFee, Waid Rogers, John Mack, J. Kent Trinkle, Frederick L. Grover

Research output: Contribution to journalArticle

56 Citations (Scopus)

Abstract

The records of 26 patients with external blunt or penetrating esophageal trauma were reviewed to determine clinical features and results of therapy. Twenty-one injuries (four blunt, 17 penetrating) were to the cervical esophagus, and five to the thoracic esophagus. Major physical signs included subcutaneous air, neck hematoma, and blood in the nasogastric tube. Helpful roentgenographic findings were cervical and/or mediastinal air, mediastinal widening, pleural effusion, and pneumothorax (15%). Nine of 12 (75%) contrast studies and five of six (83%) esophagoscopies were positive. Twenty- four patients had associated injuries, the most common of which was tracheal (14 patients) (64%). All patients were managed by prompt surgical exploration, primary closure, and drainage. There were three early deaths. Thirteen patients had postoperative complications, four of which were esophageal leaks. Two of the leaks caused mediastinitis, pleural sepsis, and led to death. They were not treated by early esophageal exclusion or excision. There were no significant strictures or esophageal sequelae in the other patients. It is concluded that early primary closure and drainage results in a relatively high incidence of survival. If a thoracic esophageal leak occurs, aggressive management of prompt esophageal exclusion or excision is necessary to control sepsis and improve survival.

Original languageEnglish (US)
Pages (from-to)784-792
Number of pages9
JournalJournal of Trauma - Injury, Infection and Critical Care
Volume25
Issue number8
DOIs
StatePublished - Jan 1 1985
Externally publishedYes

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Wounds and Injuries
Esophagus
Drainage
Sepsis
Thorax
Air
Esophagoscopy
Mediastinitis
Esophageal Stenosis
Nonpenetrating Wounds
Survival
Pneumothorax
Pleural Effusion
Hematoma
Neck
Incidence
Therapeutics

All Science Journal Classification (ASJC) codes

  • Surgery
  • Critical Care and Intensive Care Medicine

Cite this

Glatterer, M. S., Toon, R. S., Ellestad, C., McFee, A. S., Rogers, W., Mack, J., ... Grover, F. L. (1985). Management of Blunt and Penetrating External Esophageal Trauma. Journal of Trauma - Injury, Infection and Critical Care, 25(8), 784-792. https://doi.org/10.1097/00005373-198508000-00009

Management of Blunt and Penetrating External Esophageal Trauma. / Glatterer, Milton S.; Toon, Richard S.; Ellestad, Cheryl; McFee, Arthur S.; Rogers, Waid; Mack, John; Kent Trinkle, J.; Grover, Frederick L.

In: Journal of Trauma - Injury, Infection and Critical Care, Vol. 25, No. 8, 01.01.1985, p. 784-792.

Research output: Contribution to journalArticle

Glatterer, MS, Toon, RS, Ellestad, C, McFee, AS, Rogers, W, Mack, J, Kent Trinkle, J & Grover, FL 1985, 'Management of Blunt and Penetrating External Esophageal Trauma', Journal of Trauma - Injury, Infection and Critical Care, vol. 25, no. 8, pp. 784-792. https://doi.org/10.1097/00005373-198508000-00009
Glatterer, Milton S. ; Toon, Richard S. ; Ellestad, Cheryl ; McFee, Arthur S. ; Rogers, Waid ; Mack, John ; Kent Trinkle, J. ; Grover, Frederick L. / Management of Blunt and Penetrating External Esophageal Trauma. In: Journal of Trauma - Injury, Infection and Critical Care. 1985 ; Vol. 25, No. 8. pp. 784-792.
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