Unpredictable Outcome of Large Traumatic Oesophageal Injury: An Experience and Challenges

Abstract

Oesophageal injury following blunt or penetrating injury due to road traffic accidents is a rare cause of morbidity and mortality. The outcome of delayed diagnosis of oesophageal injury is mostly life threatening conditions. A 23-year-old female presented with respiratory distress, fever, chest pain and facial deformity, following road traffic accident 15 days back. After evaluation, the patient was diagnosed with septicaemia due to large thoracic oesophageal perforation with left pyothorax. The patient was managed by Video Assisted Thoracoscopic Surgery (VATS) decortication with feeding jejunostomy followed by diversion cervical oesophagostomy. The patient was planned for oesophageal reconstructive surgery electively in follow-up period. After six weeks in the follow-up period, surprisingly large thoracic oesophagus perforation and cervical oesophagostomy was healed spontaneously which was confirmed by gastrograffin study. Spontaneous closure of large thoracic oesophageal perforation is the rare outcome of this injury.

Keywords

• oesophageal perforation
• oesophagostomy
• thoracic
• trauma
• video assisted thoracoscopic surgery decortication