Document Detail


Conservative therapy for missed esophageal perforation after blunt trauma.
MedLine Citation:
PMID:  3096346     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
An 80-year-old man was treated, non-operatively, for a distal esophageal perforation, diagnosed nine days after blunt thoracic trauma. Emergency department diagnosis was impeded by absence of mediastinal air; right chest-wall emphysema was thought to result from associated rib fractures. Conservative therapy consisting of nasogastric suction, intravenous antibiotics, right-chest tube drainage of a large communicating empyema cavity, temporary nasotracheal intubation with ventilatory support, total parenteral nutrition, and, finally, nasoduodenal intubation for elemental feeding were employed. This mode of therapy may be best in comparable elderly patients with esophageal perforation that is overlooked during the initial 24 hours after injury. Possibly, routine barium swallow in all patients with chest-wall emphysema and rib fractures would circumvent missed esophageal rupture after blunt trauma.
Authors:
C E Lucas; F Splittgerber; A M Ledgerwood
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Publication Detail:
Type:  Case Reports; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The American journal of emergency medicine     Volume:  4     ISSN:  0735-6757     ISO Abbreviation:  Am J Emerg Med     Publication Date:  1986 Nov 
Date Detail:
Created Date:  1986-12-29     Completed Date:  1986-12-29     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8309942     Medline TA:  Am J Emerg Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  520-2     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Drainage
Esophageal Perforation / diagnosis,  etiology,  therapy*
Humans
Male
Parenteral Nutrition, Total
Wounds, Nonpenetrating / complications*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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