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Year : 2015  |  Volume : 12  |  Issue : 2  |  Page : 121-125

Mediastinal traversing fatal oesophageal injury from an unusual trajectory: A case report and review of literature

1 Department of Surgery, Division of Cardiothoracic Surgery, Aminu Kano Teaching Hospital, Kano, Nigeria
2 Department of Anaesthesia, Aminu Kano Teaching Hospital, Kano, Nigeria
3 Department of Surgery, Aminu Kano Teaching Hospital, Kano, Nigeria

Correspondence Address:
Jameel Ismail Ahmad
Department of Surgery, Division of Cardiothoracic Surgery, Aminu Kano Teaching Hospital, PMB 3452, Kano
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0331-8540.169288

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Oesophageal perforation is a potentially lethal clinical condition. Penetrating thoracic oesophageal injury is associated with increased morbidity and mortality, especially if the interval between the injury and commencement of treatment is delayed beyond 24 h. We present a 20-year-old man with a 2 weeks history of mediastinal traversing thoracic oesophageal injury and secondary right empyema following assault. The injury was a stab using a long knife with an entry point at the upper left arm which took an unusual trajectory to traverse the left hemithorax and the mediastinum to penetrate the oesophagus in the right hemithorax. He was resuscitated and thoracotomy was done where the perforation was repaired and the lung decorticated, but he sustained cardiac arrest and could not be resuscitated. Delayed time interval between the time of oesophageal injury and the commencement of treatment is a key determinant of patients' outcome. Prompt diagnosis and institution of treatment significantly reduce the morbidity and mortality associated with oesophageal perforation.

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