A Case of Combined Rupture of the Trachea and Esophagus following Blunt Chest Trauma for which an Approach by Median Sternotomy and the Grearter Omental Flap were Effective

Hiromichi Ishii, Mamoru Masuyama, Atsushi Matsumura, Ryou Morimura, Yoshimasa Ebihara, Hiroshi Tsuruta* and Shinsuke Watanabe

Department of Surgery and Department of Emergency Medicine*, Saiseikai Shiga Hospital

We report a case of tracheoesophageal rupture following blunt trauma. A 56-year-old man falling directly on his chest against a steel frame was conscious but his face, neck, and chest were swollen with palpable emphysema. He was immediately intubated nasally for dyspnea, and chest CT showed obvious tracheal rupture and pneumomediastium. Esophagoscopy showed esophageal rupture necessitating immediate surgery via a median sternotomy. The trachea and esophagus were repaired. The pedicled greater omentum was interposed between the trachea and the esophagus to prevent the formation of a tracheoesophageal fistula, effectively ensuring repair due to relatively low aggressive insult and good operative view.

Key words
tracheoesophageal rupture, blunt chest trauma

Reprint requests
Hiromichi Ishii Department of Surgery, Saiseikai Shiga Hospital
2-4-1 Ohashi, Rittoh, 520-3046 JAPAN

Accepted
April 27, 2005

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