Taiwan J Fam Med Vol. 26 No (22,800/mcL) 80% X (VATS esophageal repair) 2 (traumatic esophageal perforation) % (blunt trauma

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1 [] ; 26: DOI: / (traumatic esophageal perforation) 59% 0.1% ,

repair) 2 (traumatic esophageal perforation) 0.

2 Taiwan J Fam Med Vol. 26 No (22,800/mcL) 80% X (VATS esophageal repair) 2 (traumatic esophageal perforation) % (blunt trauma) (perforating trauma)43% [1] (iatrogenic) 59% [2] 9% 0.1% [3]

3 [4] [5] [6] [7] [8] [9] X X (pneumomediastinum) [10] [11] % 96% [12] [13] (primary repair) [14] Strauss 1 [6] pubmed [15] 28 (hemopneumothorax)

4 Taiwan J Fam Med Vol. 26 No.1 1 (tissue buttressing) T-tube (esophagectomy) 6 World J Emerg Surg 2007; 2: 8. [3] X [4] 1. Skipworth RJ, McBride OM, Kerssens JJ, Paterson-Brown S: Esophagogastric trauma in Scotland. World J Surg 2012; 36: Brinster CJ, Singhal S, Lee L, Marshall MB, Kaiser LR, Kucharczuk JC: Evolving options in the management of esophageal perforation. Ann Thorac Surg 2004; 77: Abdulrahman H, Ajaj A, Shunni A, et al: Blunt traumatic esophageal injury: Unusual presentation and approach. Int J Surg Case Rep 2014; 5: Muneer M, Abdelrahman H, El-Menyar A, et al: External air compression: A rare cause of blunt esophageal injury, managed by a stent. Int J Surg Case Rep 2014; 5: Blencowe NS, Strong S, Hollowood AD: Spontaneous oesophageal rupture. BMJ 2013; 346: f Strauss DC, Tandon R, Mason RC: Distal thoracic oesophageal perforation secondary to blunt trauma: case report. World J Emerg Surg 2007; 2: 8.

5 Glatterer MS Jr, Toon RS, Ellestad C, et al: Management of blunt and penetrating external esophageal trauma. J Trauma 1985; 25: Søreide JA, Viste A: Esophageal perforation: diagnostic work-up and clinical decisionmaking in the first 24 hours. Scand J Trauma Resusc Emerg Med 2011; 19: Beal SL, Pottmeyer EW, Spisso JM: Esophageal perforation following external blunt trauma. J Trauma 1988; 28: Mirvis SE: Imaging of acute thoracic injury: the advent of MDCT screening. Semin Ultrasound CT MR 2005; 26: Moreno-Ramos MD, Serrano BV: Distal esophageal perforation secondary to blunt trauma diagnosed by computed tomography. Eur J Radiol 2004; 51: Flowers JL, Graham SM, Ugarte MA, et al: Flexible endoscopy for the diagnosis of esophageal trauma. J Trauma 1996, 40: Kuppusamy MK, Hubka M, Felisky CD, et al: Evolving management strategies in esophageal perforation: surgeons using nonoperative techniques to improve outcomes. J Am Coll Surg 2011; 213: Salminen P, Gullichsen R, Laine S: Use of self-expandable metal stents for the treatment of esophageal perforations and anastomotic leaks. Surg Endosc 2009; 23: Oray NC, Sivrikaya S, Bayram B, Egeli T, Dicle O: Blunt trauma patient with esophageal perforation. West J Emerg Med 2014; 15:

6 58 [Case Report] Esophageal Perforation Caused by Blunt Trauma A Case Report Shu-Ya Tang 1, Ya-Chi Cheng 2, An-Ting Lee 2, and Hsien-Chin Tang 2 A 40-year-old male animal husbandry technician was hit on the chest wall by a pig weighted approximately 100 kilograms. Intermittent epigastric pain had been noted since the accident for days. Pain was aggravated after food intake and accompanied with mild dyspnea. After abdominal computed tomography and upper gastrointestinal series, esophageal rupture was highly suspected and operation was performed. Early diagnosis and appropriate treatment plan help reduce the complications and mortality of esophageal perforation. However, because of the initital presentation of nonspecific symptoms, early diagnosis of esophageal perforation is usually difficult. Esophageal perforation caused by non-iatrogenic blunt trauma is rare. We further discussed the mechanism, diagnosis and treatment of esophageal perforation caused by blunt trauma according to the case report and literature reviewed. (Taiwan J Fam Med 2016; 26: 53-58) DOI: / Key words: blunt trauma, esophageal perforation 1 School of Medicine, National Cheng Kung University, Tainan; 2 Department of Family Medicine, Chia-Yi Christian Hospital, Chia-Yi, Taiwan. Received: October 15, 2015; Revised: November 6, 2015; Accepted: November 9, 2015.

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