We have located links that may give you full text access.
Through-and-through gunshot wound to the esophagus at the thoracic inlet:a novel management approach.
A 42-year-old man presented to the emergency department with gunshot wound to left upper back over the scapula and palpable bullet over the right supraclavicular fossa. The patient had a left-sided needle thoracostomy in the field. He was tachypneic and tachycardiac but normortensive on arrival. Due to the patient being in respiratory distress, he was orotracheally intubated. On examination, he was found to have a moderate left pneumothorax with mild mediastinal shift. He had a left closed tube thoracostomy placed. CT angiography imaging of the neck and chest was then obtained, and pneumomediastinum associated with bony fragmentation of the anterior T1 and T2 vertebral bodies was observed. Additional findings included right internal jugular injury and right apical pulmonary hemorrhage. The patient subsequently underwent flexible tracheobronchoscopy and esophagoscopy in the endoscopy suite, where a through-and-through esophageal injury at 21 cm from the incisors was recognized (figure 1). There was erythema noted in the trachea at this level, but no evidence of transmural injury to the trachea. Figure 1Through-and-through gunshot wound to esophagus. Arrows denote areas of injury.
What would you do?: Commence 14-day course of broad spectrum antibiotics.Endoscopic stenting with video-assisted thorascopic surgery (VATS) washout.Local exploration with wide drain placement.Open esophagectomy with spit fistula.
What would you do?: Commence 14-day course of broad spectrum antibiotics.Endoscopic stenting with video-assisted thorascopic surgery (VATS) washout.Local exploration with wide drain placement.Open esophagectomy with spit fistula.
Full text links
Related Resources
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app
All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.
By using this service, you agree to our terms of use and privacy policy.
Your Privacy Choices
You can now claim free CME credits for this literature searchClaim now
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app