A Case Report of Penetrating Injury to the Cervical Esophagus Caused by a Chopstick

Yoshihiro Takashima, Masahiro Miura, Seiji Masuda

Department of Surgery, Social Insurance Takahama Hospital

A case of penetrating injury to the cervical esophagus caused by a chopstick is reported herein. The patient, a l9-year-old woman, fell while carrying dishes,and her right neck was penetrated by the chopstick. She visited our hospital without removing the chopstick, and the diagnosis of esophageal injury was established endoscopically. Extripation of the chopstick and primary closure of the esophagus was done. Thirty-five cases of traumatic esophageal injury reported in Japan, including our case, were reviewed. The mortality rate of the conservatively treated cases was 66.7% (2/3), in contrast to 3.2% (1/31) in the surgically teated cases. If primary closure is delayed beyond 24 hours of injury, the rate of leakage is 80% (4/5) in contrast to 9.1% (1/11) in within 24 hours. Three (25%) of the 12 drainage cases needed reoperation. Therefore, early diagnosis and eary surgical intervention is essential for traumatic esophageal injury. Twenty-three Japanese cases of penetrating injury by chopstick, including our case, were reviewed. In 17 cases of simple removal of the penetrating chopstick, 10 cases needed extripation of the divided piece, and 2 cases with injuries of the digestive tract, despite complete removal, needed surgical treatment later on. In selected patients with complete removal of the chopstick and without injury of the digestive tract, conservative treatment may be appropriate.

Key words
traumatic esophageal injury, penetrating injury to the cervical esophagus, penetrating injury by a chopstick

Reprint requests
Yoshihiro Takashima Department of Surgery, Social Insurance Takahama Hospital
87-14-2 Miyazaki, Takahama-cho, Ohi-gun, Fukui, 919-22 JAPAN

Accepted
January 11, 1995

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