External air compression: A rare cause of blunt esophageal injury, managed by a stent

Abstract

INTRODUCTIONBlunt esophageal injuries secondary to external air compression of anterior chest and abdomen complicated with esophageal perforation are uncommon events associated with worse outcomes.PRESENTATION OF CASEWe reported a rare case of esophageal perforation following an external air-compression injury along with the relevant review of literatures. The patient presented with chest pain and shortness of breath and was managed with tube thoracostomy, followed by thoracotomy and eventually with temporary endoscopic stenting.DISCUSSIONIn such trauma case, the external pressurized air forms a shock wave which usually directed to the hollow viscus. Patients with external air-compression injury presented with chest pain and pneumothorax should be suspected for esophageal perforation.CONCLUSIONHigh index of suspicion is needed for early diagnosis of esophageal perforation after blunt trauma. Appropriate drainage, antibiotic and temporary endoscopic esophageal stenting may be an optimal approach in selected patients, especially with delayed diagnosis.

Esophageal Rupture Due to Diving in Shallow Waters

“…Other etiologic mechanisms may include barotrauma during impact. However rare, there has been one such reported case [2]. We believe the impact may have caused a surge of air through the esophagus, causing the barotrauma.…”

“…Esophageal rupture caused distal to the carina and distal from the site of blunt injury due to barotrauma is an extremely rare event. Seventy percent of esophageal ruptures due to blunt injury are found late and have poor prognosis [1,2]. We report a rare case of distal esophageal rupture after blunt injury caused by barotrauma.…”