Blast injury to the thoracic esophagus

Esophageal perforation caused by external air-blast injury

“…The incidence of esophageal perforation caused by blast trauma is estimated to be 0.004%-0.01% [2,3]. The most commonly reported mechanism of injury is high-pressure air directed into the esophagus via the mouth [3].…”

“…The most commonly reported mechanism of injury is high-pressure air directed into the esophagus via the mouth [3]. An external air-blast contusion on the anterior chest and abdomen that induces rupture of the esophagus, as showed in Table 1, is even rare [1-4].…”

“…The most common symptoms are chest pain and dyspnea, which are not specific for esophageal rupture. Pneumomediastinum and pneumothorax are the most common findings in patients suffering from lower esophageal perforation [3]. An esophagogram should be considered for patients suffering from external air-blast injury who presented symptoms of chest pain, dyspnea or subcutaneous emphysema.…”

“…Primary repair is the most common procedure for blast-induced esophageal perforation. Guth et al performed primary repair, with gastrostomy and feeding jejunostomy for early enteral nutrition support, when esophageal perforation was diagnosed within 24 hours [3]. Although the successful primary repair of an esophageal perforation has been reported even after the diagnosis had been delayed for more than 72 hours [6], leakage and mediastinal infection are common after the procedure.…”

Conservative management of esophageal perforation due to external air-blast injury: a case report and literature review

“…Esophageal perforation caused by iatrogenic or other reasons has been reported frequently, however, barotraumatic injury caused by external air-blast is rare. Only four cases were found in the English literature when searched by Roan and Wu in 2010, and 11 cases were found in a perusal of the English and Chinese literature up to 2013 (Table 1) [Roan and Wu, 2010;Wu et al 2011;Zhu et al 2009;Zhou, 2007;Zhang et al 2006;Li et al 2000;Guth et al 1991;Michel et al 1981;Majeski and MacMillan, 1979;Volk et al 1955]. Herein, we report a case of a patient with esophageal perforation following an injury caused by a gas-tank explosion who recovered satisfactorily after conservative management.…”