Traumatic Hypopharyngeal-Cervical Esophageal Injuries

Lee, Kang Jin; Sung, Myung Whun; Park, Bum Jung; Seong, Weon Jin; Roh, Jong Lyel; Jeong, Han Sin; Lee, Seung Sin; Kim, Kwang Hyun

Abstract

BACKGROUND AND OBJECTIVES: Traumatic perforation in hypopharynx and cervical esophagus may be fatal, causing mediastinitis or sepsis. We present six cases of clinical experiences to outline diagnosis and management. MATERIALS AND METHOD: We retrospectively reviewed six patients with hypopharyngeal-cervical esophageal injury, over the period of recent two years. We summarized the method of diagnosis, treatment and clinical course with review of the literature.
RESULTS
There were two cases of external blunt trauma, two cases of iatrogenic causes, and two cases of intraluminal injuries. The common clinical signs were painful neck swelling and fever. The five of six in routine X-ray showed air shadow in the neck or chest. The neck CT showed air or abscess in all six cases. The surgical drainage was performed in four cases.
CONCLUSION
The diagnostic methods of hypopharyngeal-cervical esophageal injuries include chest X-ray, neck X-ray, Gastrografin(r) esophagography and CT after thorough history-taking and physical examination. CT was highly sensitive and important for decision of surgical management. Surgery is recommended if there is large perforation, abscess, mediastinal contamination or sepsis. In selective cases, non-surgical management is possible.