War injuries to the thoracic esophagus

Objective: Presentation of our experience in the treatment of war injuries to the thoracic esophagus at the Split University Hospital, Croatia, during the 1991-1995 wars in Croatia and Bosnia-Herzegovina, Methods: Retrospecti ve analysis of clinical and surgical data on patients with war injuries to the esophagus. Results: Of 2494 treated injured persons, 5 patients (0.2%) had injuries to the esophagus. We performed temporary double-exclusion of t he esophagus in all our patients, followed by gastric interposition after p artial esophagegtomy in three patients and simple suturing with pericardial protection of the esophagus in one patient. One of our patients died after double-exclusion due to septic complications in spite of antimicrobial che moprophylaxis regularly performed in all injured persons. Final surgical ou tcome and mortality rate (20%) In our patients were quite satisfactory. Con clusion: Prompt transportation,appropriate diagnostic methods and an adequa te surgical treatment can markedly reduce mortality and complications rate in war injuries to the thoracic esophagus. (C) 1998 Elsevier Science B.V. A ll rights reserved.