%0 Journal Article
%T Blunt Pharyngoesophageal Injuries: Current Management Strategies
%A A. A. Sayari
%A A. J. Nicol
%A D. R. Margulies
%A D. Serna-Gallegos
%A E. J. Ley
%A G. Barmparas
%A P. H. Navsaria
%A S. Edu
%J Scandinavian Journal of Surgery
%@ 1799-7267
%D 2018
%R 10.1177/1457496918766692
%X Blunt pharyngoesophageal injuries pose a management challenge to the trauma surgeon. The purpose of this study was to explore whether these injuries can be managed expectantly without neck exploration. The National Trauma Databank datasets 2007¨C2011 were reviewed for blunt trauma patients who sustained a pharyngeal injury, including an injury to the cervical esophagus. Patients who survived over 24£¿h and were not transferred from other institutions were divided into two groups based on whether a neck exploration was performed. Outcomes included mortality and hospital stay. A total of 545 (0.02%) patients were identified. The median age was 18£¿years and 69% were male. Facial fractures were found in 16%, while 13% had an associated traumatic brain injury. Of the 284 patients who survived over 24£¿h and were not transferred from another institution, 65 (23%) underwent a neck exploration. The injury burden was significantly higher in this group as indicated by the higher median Injury Severity Score (17 vs 10, p£¿<£¿0.01) and need for intensive care unit admission (75% vs 31%, p£¿<£¿0.01). The overall mortality was 2%: 3.1% for neck explorations versus 1.6% for conservative management (adjusted p£¿=£¿0.54). Neck exploration patients were more likely to remain longer in the hospital (median 13 vs 10£¿days, adjusted p£¿=£¿0.03). Pharyngoesophageal injuries are rare following blunt trauma. Only a quarter require a neck exploration and this decision appears to be dictated by the injury burden. Selective non-operative management based on clinical status seems to be feasible and is not associated with increased mortality
%K Pharyngeal injuries
%K pharyngoesophageal injuries
%K neck trauma
%K blunt trauma
%K nonoperative management
%U https://journals.sagepub.com/doi/full/10.1177/1457496918766692