POSTTRAUMATIC ESOPHAGEAL HEMATOMA

A 20-year-old man was admitted after a traffic accident for a closed c hest trauma. Initial evaluation showed a sternal fracture with a minor pneumomediastinum. Twenty-four hours later be experienced an acute re spiratory failure, due to total left pulmonary atelectasis from indire ct compression of the left main stem bronchus. Mediastinal widening at the postero-superior level was visualized by CT scan. The aortogram w as normal. Thoracotomy showed a moderate left haemothorax, associated with an intramural haematoma of the low thoracic oesophagus which was respected. The time course was uneventful, except repetitive atelectas es treated by fibrescopic aspiration. Oesophageal haematoma secondary to chest trauma is a rare injury, with around 10 cases reported in the literature. Compression of tracheobronchial axis is exceptional. Beca use of the delayed occurrence of such a complication after chest traum a, with sternal fracture, close clinical surveillance and CT scans are essential.