Complicaciones Asociadas Al Trauma Penetrante de Esófago, Experiencia De 11 Años En El Hospital Universitario de Neiva

Abstract

Background: Penetrating esophageal lesions are extremely rare, less than 0.5%. They are related to high morbidity 30--66% and mortality ~20%. There is a diagnostic and therapeutic challenge, given its severity requires a timely approach and aggressive management to avoid sequelae and complications. Study design: Descriptive subgroup analysis of a retrospective cohort (2003--2013) of patients with surgical trauma. The severity of the trauma was assessed using the AAST classification. Results: Of the total 2,390 cases of registered surgical trauma, 10 (0.4%) corresponded to an esophageal trauma. All cases were observed in men with a median age of 26 years (IQR = 19--35). The cause of the most frequent injury was gunshot injury in six patients, followed by blunt gun injury in two patients and blast wave in the two remaining patients. The RTS in the majority of the patients was 7.84 (IQR = 7.47--7.84). The severity of esophageal trauma was grade II in seven patients and grade III in three patients. Associated vascular lesions were observed in two patients. All patients were taken to repair the primary lesion. The most frequent complication was esophageal tracheal fistula in four patients. A total of seven patients required reintervention, 71% for lesions directly related to esophageal lesion. No mortality was shown. Conclusion: Esophageal lesions in surgical management trauma are infrequent, no deaths were observed in this series. Complications are common, the most commonly related is tracheoesofagic fistula, the reinterventions present an adequate evolution Keywords: Esophageal trauma, Tracheoesofagic fistula, Tracheostomy, gastrostomy.