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J Thorac Cardiovasc Surg 2006;132:1495-1496
© 2006 The American Association for Thoracic Surgery

Brief Communication

Successful early repair of a traumatic tracheoesophageal fistula after blunt chest trauma

James M. O’Riordan, MD, MRCSIa,*, Niall Hickey, FFR, RCSIc, Oleg Ilinski, FCA, RCSIb, Parnell Keeling, MCh, MRCSIa, Thomas N. Walsh, MD, MRCSIa

a Department of Surgery, Connolly Hospital, Blanchardstown, Dublin, Ireland
b Department of Anaesthesia, Connolly Hospital, Blanchardstown, Dublin, Ireland
c Department of Radiology, Connolly Hospital, Blanchardstown, Dublin, Ireland.

Received for publication July 9, 2006; accepted for publication August 8, 2006.

* Address for reprints: James O’Riordan, Connolly Hospital, Blanchardstown, Dublin 15, Ireland (Email: JamORiordan@rcsi.ie).

The first 20% of the full text of this article appears below.

Tracheoesophageal fistula after blunt chest trauma is rare and usually presents after an asymptomatic interval. We report a case of acute traumatic tracheoesophageal fistula recognized immediately and treated successfully.

Clinical Summary

A 19-year-old man was the unrestrained driver of a car involved in a head-on collision with a wall. His car was not fitted with air bags, and he was found by the ambulance crew lying on the side of the road, having crawled out of the car. He arrived in the casualty department 30 minutes later. His pulse rate on arrival was 130 beats/min, blood pressure was 130/100 mm Hg, PaO 2 was 8.0 kPa, oxygen saturation was 80% on 100% O2, and Glasgow Coma Scale score was 11 of 15. His main injuries on presentation were small bilateral pneumothorax, widespread subcutaneous emphysema, compound fractures of the right femur and right tibia, and closed fractures of the left femur and left fibula. Because of deteriorating oxygen saturation, he was intubated and ventilated. Bilateral chest drains were inserted, and his orthopedic injuries were stabilized with Thomas’s splints.

A computed tomogram showed liver and splenic lacerations, blood . . . [Full Text of this Article]






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