Cervical esophageal perforation secondary to blunt trauma is extremely rare. A case of an 8-week-old infant that sustained a cervical esophageal perforation from abusive acceleration/deceleration blunt trauma is presented. Early diagnosis and appropriate intervention of an already insidious injury can be further delayed by the lack of concise temporal events and falsification of data from the abusive caretaker(s). In-depth history taking, documentation and notification of authorities lays the critical medicolegal groundwork for this unfortunately increasing problem in our society. Diagnosis and management are discussed. The pediatrician, emergency department, nursing staff and otolaryngologist should have strong suspicions of abuse when esophageal perforation is identified in an infant.
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