Management of esophageal gunshot wounds

L. J. Pass, L. A. LaNarz, J. T. Schreiber, A. S. Estrera

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

The records of 20 patients with gunshot wounds of the esophagus seen from 1973 through 1985 were reviewed. Nine perforations were cervical, 10 were thoracic, and 1 was abdominal. Because physical findings and plain roentgenograms lack specificity, a high index of suspicion based on the path of the bullet tract is essential for early diagnosis. Esophageal injury should especially be suspected when the bullet wound is transcervical or transmediastinal. Perforation was diagnosed by esophagoscopy in 9 patients, esophagography in 4, and surgical exploration in 7. Mean time from admission to operation was 3.8 hours. Associated injuries occurred frequently. Eighteen patients were treated by primary closure and wide drainage, and 2 were managed by esophageal exclusion. There were 2 perioperative deaths, both in patients with associated aortic injuries, and 1 late death, for an overall mortality of 15%. There was one postoperative leak following a cervical repair. No leaks occurred in patients having a thoracic repair. The findings indicate that esophageal perforation must be sought by a variety of methods. With prompt diagnosis and early operation, primary repair can be safely accomplished. When sepsis from esophageal leak is avoided, mortality and major morbidity are related to associated injuries.

Original languageEnglish (US)
Pages (from-to)253-256
Number of pages4
JournalAnnals of Thoracic Surgery
Volume44
Issue number3
StatePublished - 1987

Fingerprint

Gunshot Wounds
Wounds and Injuries
Thorax
Esophagoscopy
Esophageal Perforation
Mortality
Esophagus
Early Diagnosis
Drainage
Sepsis
Morbidity

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Pass, L. J., LaNarz, L. A., Schreiber, J. T., & Estrera, A. S. (1987). Management of esophageal gunshot wounds. Annals of Thoracic Surgery, 44(3), 253-256.

Management of esophageal gunshot wounds. / Pass, L. J.; LaNarz, L. A.; Schreiber, J. T.; Estrera, A. S.

In: Annals of Thoracic Surgery, Vol. 44, No. 3, 1987, p. 253-256.

Research output: Contribution to journalArticle

Pass, LJ, LaNarz, LA, Schreiber, JT & Estrera, AS 1987, 'Management of esophageal gunshot wounds', Annals of Thoracic Surgery, vol. 44, no. 3, pp. 253-256.
Pass LJ, LaNarz LA, Schreiber JT, Estrera AS. Management of esophageal gunshot wounds. Annals of Thoracic Surgery. 1987;44(3):253-256.
Pass, L. J. ; LaNarz, L. A. ; Schreiber, J. T. ; Estrera, A. S. / Management of esophageal gunshot wounds. In: Annals of Thoracic Surgery. 1987 ; Vol. 44, No. 3. pp. 253-256.
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