[Study of 58 intrathoracic complications in 166 accidental or iatrogenic esophageal injuries].

In 58 patients among 166 cases of esophageal trauma who developed an intrathoracic complication, the cases are studied of 26 esophageal instrumental perforations, 10 vomiting or effort ruptures, 14 ingestions of foreign bodies (observed in a surgical unit), 5 corrosions by acids or alkalis and 3 esophageal injuries after closed chest trauma. Some complications occurred or were recognized after a delay of 1 to 16 days. In 22 cases treated after the second day, 9 patients survived and in 18 cases treated after 4 days, 6 patients nevertheless survived. The outcome is difficult to assess initially but hope must be entertained even in the most severe cases. The discussion focuses on symptoms and signs, modes of clinical presentation and the different types of fistulas (4 intramural, 31 esophago-mediastinal, 15 esophago-pleural, 5 esophago-tracheal, 1 esophago-aortic, 1 esophago-pericardial). Treatment varies with the delay in diagnosis and is often complex. In cases requiring reoperation the mortality is very high.