Distal thoracic oesophageal perforation secondary to blunt trauma Case report.docVIP

World Journal of Emergency Surgery BioMedCentral Case report Open Access Distal thoracic oesophageal perforation secondary to blunt trauma: Case report Dirk C Strauss, Ruchi Tandon and Robert C Mason* Address: Department of General Surgery, St. Thomas Hospital, Lambeth Palace Road, London SE1 7EH, UK Email: Dirk C Strauss - dirkcstrauss@yahoo.co.uk; Ruchi Tandon - rc_tandon@; Robert C Mason* - Robert.Mason@gstt.nhs.uk * Corresponding author Published: 21 March 2007 Received: 8 November 2006 Accepted: 21 March 2007 World Journal of Emergency Surgery 2007, 2:8 doi:10.1186/1749-7922-2-8 This article is available from: /content/2/1/8 ? 2007 Strauss et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract Background: Traumatic perforation of the distal oesophagus due to blunt trauma is a very rare condition and is still associated with a significant morbidity and mortality. This is further exacerbated by delayed diagnosis and management as symptoms and signs are often masked by or ascribed to more common blunt thoracic injuries. Case report: We present a case of a distal oesophageal perforation, secondary to a fall from a third storey window, which was masked by concomitant thoracic injuries and missed on both computed tomography imaging and laparotomy. The delay in his diagnosis significantly worsened the patients recovery by allowing the development of an overwhelming chest sepsis that contributed to his death. Conclusion: Early identification of an intrathoracic oesophageal perforation requires deliberate consideration and is essential to ensure a favorable outcome. Treatment should be individualised taking into account the nature of the oesophageal defe