Abstract
A 75-year-old man was hit by a car and taken by ambulance to hospital. He had quadriparesis on arrival. The chest CT and MRI revealed a right hemothorax, mediastinal hematoma, cervical cord compression, cervical fracture, and a third thoracic vertebral burst fracture. He developed dyspnea on the 4th day and required artificial venitilation. A right bloody pleural effusion was observed on the same day, and a purulent effusion was noted the next day. The chest CT showed a right pneumothorax and mediastinal emphysema. Esophageal perforation was confirmed by endoscopy on the 6th day. Therefore, a traumatic esophageal rupture was diagnosed. The patient had a partial esophagectomy and esophagostomy with a cervical incision, a gastrostomy, and a jejunostomy. The esophageal rupture was thought to have been caused by a thoracic vertebral fracture segment. Traumatic esophageal rupture is rare. This is the first case of esophageal rupture following thoracic vertebral fracture seems to reported in Japan. It is important to diagnose and treat such cases. Therefore, esophageal rupture should ruled out in patients with thoraco-abdominal trauma.
