Total Esophageal Avulsion at the Esophagogastric Junction after Blunt Trauma

Abstract

Total avulsion and transection of the esophagus at the esophagogastric junction are very rare after blunt trauma, and their management is challenging. Here, we present the case of a boy with this injury. To date, only two cases have been reported in children. One was treated successfully and the other died. The initial emergency operation should aim to save the life and native esophagus. Therefore, a primary or early thoracal end esophagostomy with gastrostomy should be performed, while primary repair should not be.

Pediatric Blunt Thoracic Trauma

“…Esophageal perforation from blunt thoracic injury is very rare in children resulting in only a few cases having been described in the English language literature. [49][50][51][52][53][54] Associated injuries are common and diagnosis can be difficult. Diagnosis is often delayed, because with blunt injury, as opposed to penetrating injury, the index of suspicion for esophageal injuries is typically low, and the associated signs and symptoms often also present in a delayed and nonspecific fashion, particularly if the injury is contained and presents later as an acquired tracheoesophageal fistula.…”

Complete gastroesophageal junction avulsion after near drowning: A case report and review of literature

“…Compared to the adult population, only three cases of GE junction injuries are reported in children, to the best of our knowledge [ [2] , [3] , [4] ]. All of them were secondary to blunt trauma and had complete avulsion of the GE junction.…”

“…In the second and the third case, proximal diversion and delayed reconstruction were performed. Both patients had favorable outcomes [ 3 , 4 ].…”

“…In children, these injuries are exceedingly rare and can be a challenge to manage. Complete GE junction avulsion is an infrequently encountered entity in the pediatric population with only three cases reported in the literature previously [ [2] , [3] , [4] ]. Herein, we report the case of a 14-year-old boy who presented with a complete GE junction separation after a near-drowning experience and cardiopulmonary resuscitation (CPR).…”

Blunt Injury to the Aorta, Esophagus, and Diaphragm

“…There are no published guidelines to direct management though decisions typically follow similar algorithms for esophageal perforation due to any cause. Case reports combined with literature reviews still dominate the recent literature on this uncommon entity [38][39][40].…”