轮胎爆炸致食管破裂的手术治疗

目的 探讨轮胎爆炸致食管破裂的临床特点及误诊原因,提出防范措施.方法 对我院收治的1例轮胎爆炸伤致食管破裂患者的临床资料进行回顾性分析.结果 入院时检查右侧气胸,右肺压缩60%,左眼出血、左眼泪小管断裂,头颅CT示:蛛网膜下腔出血.急诊收住眼科治疗.胸科会诊放置胸腔闭式引流管处理.后出现液气胸,胸腔引流管中引流出浑浊胸水,行胸部CT检查明确诊断食管破裂.受伤后28 h转入胸外科,二期手术治疗痊愈出院.结论 轮胎爆炸致食管破裂比较罕见、少见,易误诊.首诊时要尽早行胸部CT、食管造影等检查,以尽早明确诊断,尽早手术治疗.

Surgical treatment of esophageal rupture caused by tire explosion

Objective To discuss the clinical features and the reasons of misdiagnosis of esophageal rupture caused by tire explosion,and to put forward countermeasures.Methods A retrospective analysis of clinical data was made in 1 case of esophageal rupture caused by tire explosion.Results The examination indicated that there existed pneumothorax in the right chest with 60% lung compression.Hemorrhage was found in the left eye,and the left lacrimal ductule was broken.The cranial CT indicated the occurrence of subarachnoid hemorrhage.The patient was admitted to the department of ophthalmology.After the consultation of cardiothoracic surgery,closed drainage tube of thoracic cavity was inserted.Hydropneumothorax occurred after the insersion.Turbid pleural effusion was drained out,and definite diagnosis of esophageal rupture was made by chest CT.Twenty eight hours after the injury,the patient was transferred to the cardiothoracic surgery,and was healed and discharged after the secondary operation.Conclusion The case of esophageal rupture caused by tire explosion is very rare and likely to be misdiagnosed.Chest CT examination and esophagography should be made as early as possible in order to make a definite diagnosis and an early surgical treatment.