Dr.JEYASEKHARAN MEDICAL TRUST

Dr.JEYASEKHARAN HOSPITAL & NURSING HOME

KP ROAD, NAGERCOIL, SOUTH INDIA 629003

An NABH accredited and ISO 9001:2015 & ISO 14001:2015 certified multispeciality hospital

EMERGENCY HELPLINE 9842110008
APPOINTMENT/ENQUIRIES 94887 81573/94431 39663
DR.JEYASEKHARAN HOSPITAL & NURSING HOME
KP ROAD, NAGERCOIL, SOUTH INDIA 629003
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case 3 through and through penetrating cervical esophageal injury

THROUGH AND THROUGH PENETRATING CERVICAL ESOPHAGEAL INJURY – A CASE REPORT

 A 25 year old male presented to emergency department within 2 hours of accidental penetrating injury to neck while handling a machine grinder at the work place.

He had a laceration measuring 3 x 1 cm in Zone 1 of the neck about 3 cm above the suprasternal notch and medial to sternocleidomastoid muscle. (figure 1)

There was saliva coming out from the wounds, which lead to suspicion of esophageal injury. He had minimal subcutaneous emphysema in neck

After giving prophylactic iv antibiotics, within 6 hrs neck exploration was done with an oblique cervical incision along the anterior border of the sternocleidomastoid muscle

Operative finding showed through and through perforation of esophagus (Figure 2).

 No airway injury was seen. In view of minimal contamination and early presentation, it was decided to do primary repair.

Posterior layer was repaired with 3-0 polyglactin interrupted sutures.

Ryle’s tube was positioned and anterior layer was approximated with 3-0 polyglactin. Drain was placed. Wound closed.

Feeding jejunostomy was done

 IV antibiotics were continued post operatively.

 Ryle’s tube was removed on 6th post op day.

 Barrium swallow study was done on 9th post op day which showed no leakage. Hence he was started on oral liquids which he tolerated well.

He was discharged after removal of drain and clips.

 On follow up patient had no complications and was doing well.