Esophageal Perforation Following Explosive Injury: A Case Report.

Esophageal perforations, though rare, are critical injuries because of the risk of rapid progression to mediastinitis and sepsis. Traumatic perforations, especially those following blunt trauma, carry high mortality, and explosive injuries may cause such damage. Here, we describe the case of a 38-year-old male with a history of opioid use disorder and hepatitis C who suffered a mid-esophageal perforation after a pressurized diesel fuel cap exploded, hitting his face. He presented with intraoral burns, chest pain, subcutaneous emphysema, and pneumomediastinum. Endoscopic evaluation confirmed the perforation, and he was successfully treated with esophageal stenting and IV antibiotics. Follow-up imaging showed no persistent leak, and he was discharged with plans for stent removal. This case highlights the importance of considering esophageal injury in explosive trauma and suggests that while endoscopic management is effective, operative readiness is crucial in resource-Xlimited and military settings, where explosive trauma is more common.