Thoracic Esophageal Perforation After Blunt Trauma in a Child: A Delayed Diagnosis and Surgical Management

Abstract

Esophageal rupture due to external blunt trauma is extremely rare in children. A-13-year old boy was admitted to emergency room with shortness of breath and abdominal pain. His history revealed fall down from 3 metres height, falling of a wooden block over chest, 4 hours before at home. Thoracic esophageal perforation was diagnosed at the 6th day of hospital stay. Surgical management was planned and right-sided thoracotomy was performed at the 7th day after admission. The esophageal layers were closed primarily and separately after muscular and mucosal debridement. Reinforcement of the primary repair was done with pleural and intercostal muscle flaps. The esophagus was tied with absorbable sutures at proximal and distal parts of the perforation to block the esophageal passage. Gastrostomy and jejunostomy were performed for nutrition. We report here a successful management with primary repair of this esophageal perforation of late diagnosis.