BACKGROUND: Diagnosis of penetrating pharyngeal and esophageal injuries are difficult when the patient has severe facial injuries, is obese or intubated, and hemodynamically unstable. Radiologic aids may be either unsuitable or unreliable. Videoendoscopy, preferably by the trauma surgeon, affords direct visualization at the bedside and is timely and expeditious. METHODS: Patients included in the study had penetrating injuries to the face/neck or torso. Evaluation began with careful assessment of the trajectory, followed by videoendoscopy and a contrast study. Data collected included the accuracy of diagnosis (compared with anatomic findings), time required to perform the studies, and complications resulting from both tests and repair. RESULTS: Thirty-three patients were included in the study. Contrast study detected all esophageal injuries, but failed to detect any hypopharyngeal injuries particularly in the intubated patients. Videoendoscopy detected all injuries, hypopharyngeal and esophageal in intubated and nonintubated patients. CONCLUSIONS: Radiologic studies should not be used for pharyngeal injuries. Although radiologic studies accurately diagnosed penetrating injuries of the esophagus, it is not as expeditious as videoendoscopy performed by the trauma surgeon. Videoendoscopy should be part of the trauma surgeons' armamentarium.
BACKGROUND: Diagnosis of penetrating pharyngeal and esophageal injuries are difficult when the patient has severe facial injuries, is obese or intubated, and hemodynamically unstable. Radiologic aids may be either unsuitable or unreliable. Videoendoscopy, preferably by the trauma surgeon, affords direct visualization at the bedside and is timely and expeditious. METHODS:Patients included in the study had penetrating injuries to the face/neck or torso. Evaluation began with careful assessment of the trajectory, followed by videoendoscopy and a contrast study. Data collected included the accuracy of diagnosis (compared with anatomic findings), time required to perform the studies, and complications resulting from both tests and repair. RESULTS: Thirty-three patients were included in the study. Contrast study detected all esophageal injuries, but failed to detect any hypopharyngeal injuries particularly in the intubated patients. Videoendoscopy detected all injuries, hypopharyngeal and esophageal in intubated and nonintubated patients. CONCLUSIONS: Radiologic studies should not be used for pharyngeal injuries. Although radiologic studies accurately diagnosed penetrating injuries of the esophagus, it is not as expeditious as videoendoscopy performed by the trauma surgeon. Videoendoscopy should be part of the trauma surgeons' armamentarium.
Authors: Daniel Dante Yeh; John O Hwabejire; Marc de Moya; David R King; Peter Fagenholz; Haytham Ma Kaafarani; Eric N Klein Journal: J Emerg Trauma Shock Date: 2015 Jan-Mar
Authors: Mircea Chirica; Michael D Kelly; Stefano Siboni; Alberto Aiolfi; Carlo Galdino Riva; Emanuele Asti; Davide Ferrari; Ari Leppäniemi; Richard P G Ten Broek; Pierre Yves Brichon; Yoram Kluger; Gustavo Pereira Fraga; Gil Frey; Nelson Adami Andreollo; Federico Coccolini; Cristina Frattini; Ernest E Moore; Osvaldo Chiara; Salomone Di Saverio; Massimo Sartelli; Dieter Weber; Luca Ansaloni; Walter Biffl; Helene Corte; Imtaz Wani; Gianluca Baiocchi; Pierre Cattan; Fausto Catena; Luigi Bonavina Journal: World J Emerg Surg Date: 2019-05-31 Impact factor: 5.469