Hypopharyngeal perforation caused by blunt trauma in buffalo attack

Area of Science:

• Trauma surgery
• Otolaryngology
• Emergency medicine

Background:

• Traumatic injuries can present with unusual findings.
• Buffalo-related incidents are rare but can cause significant blunt force trauma.

Observation:

• A male patient sustained chest and abdominal trauma after being pinned by a buffalo.
• Imaging revealed retropharyngeal free gas, prompting further investigation.
• Endoscopic evaluation identified a hypopharyngeal tear at the cricopharyngeal sphincter.

Findings:

• Despite the free gas, a gastrograffin swallow confirmed no esophageal leak.
• Conservative management was initiated with intravenous dexamethasone and antibiotics (ceftriaxone/metronidazole).

Implications:

• This case highlights the importance of thorough investigation for free gas, even with seemingly minor external injuries.
• Conservative management can be effective for hypopharyngeal tears in select trauma cases.
• Prompt diagnosis and multidisciplinary care are crucial for optimal outcomes in rare trauma presentations.