Isolated Blowout Distal Esophageal Injury From Blunt Thoraco-Abdominal Trauma Following Airbag Deployment in an Unrestrained Driver: A Case Report.

Esophageal perforation from blunt trauma is rare. It is more frequently encountered in a penetrative mechanism where the cervical esophagus is most commonly injured. Blunt esophageal injury is challenging to diagnose with nonspecific findings clinically and radiologically within trauma settings. The main factors contributing to difficulty in early recognition are its scarce occurrence combined with nonspecific manifestations clinically on patient examination and radiologically on usual trauma computed tomography with intravenous contrast. We report a case of a 15-year-old young man who sustained an isolated distal blowout esophageal perforation as a result of blunt thoraco-abdominal trauma. Despite early primary surgical repair, a leak developed later on, which was managed with stent placement. The leak and associated sepsis were resolved, with an overall status improvement and no subsequent complications. We report an unusual presentation of esophageal perforation from blunt trauma, which was promptly diagnosed and managed with multiple modalities. This case highlights the importance of early recognition and management of esophageal injury and, furthermore, the role of multiple diagnostic and therapeutic modalities that lead to a successful outcome.

An Emergency Adaptation of Anterolateral and Clamshell Thoracotomy for Blunt Traumatic Right Atrial Rupture: A Case Report.

The high mortality rate of blunt cardiac injuries is primarily due to the condition's severity and the challenges associated with pre-hospital survival. The absence of definitive diagnostic modalities necessitates prompt and adaptable surgical intervention. We present an 18-year-old male who sustained a right atrial blunt traumatic cardiac rupture following a motor vehicle collision. Despite initial stabilization with blood products and vasopressors and the necessitated emergent surgical exploration, the case required various surgical techniques, including anterolateral followed by an extension to a clamshell thoracotomy and laparotomy to manage the complex cardiac rupture and associated injuries. Furthermore, it underscores the critical nature of surgical incision in such patients and its impact on the overall prognosis. The successful outcome, highlighted by intraoperative decision-making and proper postoperative care, demonstrates that with timely and adaptable surgical approaches, even the most severe cases of traumatic blunt cardiac ruptures can be managed effectively.