Rupture Oesophagus (b)

 

This  10 year old UAE national boy sustained  blunt trauma to the chest on 9/3/87 when a TV set fell down over his chest.

He was brought to accident and emergency  (A/E) department on the same day of the accident.

He came walking with his parents and was seen and examined by A/E doctor. The child was clinically intact and x-ray chest

did not show any abnormality. The child was discharged and given appointment to the outpatient clinic to be followed up.

Next day, the child was brought back to A/E. He was looking ill, toxemic, with fever and chills.

the possibility of having hidden visceral lesion.

Barium (Ba) swallow and follow through was done. Leakage of Ba at the upper 1/3 of the oesophagus was seen denoting

rupture of the oesophagus at this portion. The child was admitted immediately to ICU. image1 and image2

Conservative treatment started :

    1- Antibiotics
    2- Nasogastric tube was inserted for continuous drainage.
    3- Bilateral intercostal drainage tubes were inserted and connected to underwater seal system.

N:B Although the mediastinal pleura was intact but in case of its detachment, Leakage of air and fluid into pleural cavity may take place.

See  image1, image2,

Observation:

The child did well on conservative treatment. see Ba swallow on 5/4/87 which showed:

          No more leakage from the rupture site. See image1, image2

The child was discharged and followed up in outpatient clinic. He did clinically well and follow up x-ray chest

was normal with clear both lung fields. See image
       

 

End