ESOPHAGEAL TRAUMA

Course overview

ESOPHAGEAL INJURY (EI) IS A RARE BUT CHALLENGING CLINICAL FINDING IN THE SETTING OF TRAUMA. ESOPHAGEAL INJURIES OR PERFORATIONS ARE TRANSMURAL DISRUPTIONS OF THE ESOPHAGUS THAT SUBSEQUENTLY LEAD TO LEAKAGE OF INTRALUMINAL CONTENTS INTO THE SURROUNDING MEDIASTINUM. THIS CAUSES LOCAL INFLAMMATION, SYSTEMIC INFLAMMATORY RESPONSE, AND EVENTUALLY CAN LEAD TO THE DEVELOPMENT OF SEPSIS, WHICH IS ASSOCIATED WITH HIGH MORBIDITY AND MORTALITY. ESOPHAGEAL INJURIES ARE MOST COMMONLY IATROGENIC, SUCH AS INJURY INCURRED DURING ENDOSCOPIC EXAM, NASO-ENTERIC TUBE PLACEMENT, OR SURGICAL PROCEDURES; HOWEVER TRAUMATIC INJURIES ALSO MAY OCCUR AND MAY BE DUE TO BLUNT TRAUMA SUCH AS A MOTOR-VEHICLE ACCIDENT OR PENETRATING TRAUMA SUCH AS A GUNSHOT OR STAB WOUND. OTHER MISCELLANEOUS MECHANISMS INCLUDE FOREIGN BODY INGESTION, SPONTANEOUS RUPTURE, SUCH AS IN BOERHAAVE SYNDROME, AND INGESTION OF ACID/CAUSTIC SUBSTANCES. THIS ACTIVITY EXPLAINS WHEN ESOPHAGEAL TRAUMA SHOULD BE CONSIDERED, ARTICULATES HOW TO PROPERLY EVALUATE FOR THIS TYPE OF INJURY, AND HIGHLIGHTS THE ROLE OF THE INTERPROFESSIONAL TEAM IN CARING FOR PATIENTS WITH THIS CONDITION.