This 10 year old UAE national boy sustained blunt trauma to the chest on 9/3/87 when a TV set fell down over his chest.
He was brought to accident and emergency (A/E) department on the same day of the accident.
He came walking with his parents and was seen and examined by A/E doctor. The child was clinically intact and x-ray chest
did not show any abnormality. The child was discharged and given appointment to the outpatient clinic to be followed up.
Next day, the child was brought back to A/E. He was looking ill, toxemic, with fever and chills.
the possibility of having hidden visceral lesion.
Barium (Ba) swallow and follow through was done. Leakage of Ba at the upper 1/3 of the oesophagus was seen denoting
rupture of the oesophagus at this portion. The child was admitted immediately to ICU. image1 and image2
Conservative treatment started :
2- Nasogastric tube was inserted for continuous drainage.
3- Bilateral intercostal drainage tubes were inserted and connected to underwater seal system.
N:B Although the mediastinal pleura was intact but in case of its detachment, Leakage of air and fluid into pleural cavity may take place.
See image1, image2,
The child did well on conservative treatment. see Ba swallow on 5/4/87 which showed:
No more leakage from the rupture site. See image1, image2
The child was discharged and followed up in outpatient clinic. He did clinically well and follow up x-ray chest
was normal with clear both lung fields. See