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[Ruptura of the thoracic esophagus due to closed abdominal trauma]
A S Cabral Júnior1, G Furlanetto, P F Silva
1Serv. de Cir. Pediát., Fac. de Med. de Santo Amaro, Hosp. Benef. Portuguesa de São Paulo.
Insights
A rare pediatric esophageal rupture from blunt abdominal trauma required esophagectomy after initial repair failed. Esophageal reconstruction with esophagocoloplasty led to a successful 5-year outcome in this case study.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Trauma Surgery
Background:
- Blunt abdominal trauma in children is uncommon.
- Esophageal rupture presents a significant surgical challenge.
Observation:
- A 5-year-old girl sustained esophageal lacerations from a washtub fall.
- Initial surgical repair with gastrostomy and parenteral nutrition failed, leading to recurrent esophago-pleural fistula.
Findings:
- An esophagectomy and cervical esophagostomy were ultimately necessary.
- Esophageal reconstruction via esophagocoloplasty achieved a cure after 5 years of follow-up.
Implications:
- This case highlights the complexities of pediatric esophageal trauma.
- While conservative management is preferred, extensive interventions may be required for severe injuries.
- Esophagocoloplasty is a viable option for esophageal reconstruction in children.
Abstract:
The authors present a rare case of closed abdominal trauma in a five year old girl resulting from a washtub fall on her causing three lacerations in the middle third of the esophagus, identified 48 hours after the trauma. The stitcher surgical treatment of the lacerations associated with gastrostomy and lengthy parenteral nutrition did not prevent the recurrence of the esophagus-pleural fistula, and an esophagectomy plus cervical esophagostomy was required. After a 10-month follow-up, the digestive passage was reconstructed by an esophagocoloplasty. At present, after 5 years of follow-up, the patient is cured. The authors discuss the causes of esophagus rupture in children and its etiopathogeny. They propose that preservativement the esophagus is the best initial treatment, in spite of the foot that this procedure was ineffective in the present case.