Abstract
Introduction : Esophageal perforation secondary to blunt trauma carries a high morbidity and mortality rates. It is a rare disease. Cervical esophagus is the commonest site of perforation. Numerous options are available for the management of esophageal injuries. The conservative medical management is allowed in well defined cases. Case presentation : We report a rare clinical case of a 40-year- old patient who was injured in a car accident with an impact to the anterior chest. At the time of admission, the patient was alert and complained of chest pain. Clinical findings showed of subacute ischemia in the right upper limb. Chest computed tomography (CT) with intraveinous contrast showed thrombosis of the brachiocephalic artery “a few air bubbles, in the upper mediastinum and a bilateral pneumothorax”. The diagnosis of esophageal perforation was confirmed by a second CT with ingestion of a water-soluble contrast agent. Outcome was favourable on antibiotics and parenteral nutrition. Conclusion : Provided that no clinical signs of sepsis are present and that the patient rapidly improves the conservative management of traumatic perforation of the thoracic oesophagus is a sounded option.
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