PENETRATING EXTERNAL INJURIES OF THE ESOPHAGUS AND PHARYNX

Fifty-one instances of oesophageal perforation were discovered when th e records of 18 588 patients with external penetrating injuries of the neck, chest and abdomen were reviewed. Of these, 33 resulted from sta b wounds, 17 from bullets and one from hyperextension of the neck. The re were 15 perforations of the pharynx and 36 of the oesophagus. Oesop hagography in a lateral decubitus position demonstrated the perforatio n in all 16 patients in whom it was used. In 45 patients simple repair within 24 h of injury was performed (mortality rate 11 per cent). In six patients with a delay of more than 24 h in the repair of the thora cic oesophagus, special techniques were preferred. In two patients an oesophageal diversion-exclusion method was used; one such patient died . In four patients repair over a large-bore T tube was carried out wit h one death. The main cause of mortality was associated spinal injury (four deaths).