Initial Surgical Management of Penetrating Neck Trauma With an Esophageal Injury: A Case Report

Esophageal perforation secondary to penetrating trauma is rare but potentially life-threatening and associated with high morbidity. We present the case of a 24-year-old male who arrived at the emergency department with a penetrating neck wound from a firearm projectile. He was hemodynamically stable upon arrival, and imaging studies suggested esophageal injury. Surgical exploration confirmed a Grade III esophageal laceration involving more than 50% of the anterior wall. Primary repair with a two-layer closure and an omohyoid muscle flap was performed. The postoperative course was favorable, with no evidence of fistula or leakage on esophagogram. The patient resumed oral intake and was discharged in good condition seven days post-trauma. This case highlights the importance of early recognition, imaging, and aggressive surgical management of esophageal injuries in penetrating neck trauma to reduce morbidity and improve outcomes.