title: Successful management of esophageal perforation diagnosed 3 days after injury caused by an explosion in the workplace: report of a case.
abstract: We report a case of esophageal perforation caused by an explosion, but which was not diagnosed until 3 days after the injury. A 53-year-old worker sustained superficial dermal burns to his trachea, face, neck, and legs during an explosion. The burns were treated conservatively at a local hospital, but he was transferred to our hospital 3 days after the injury, when mediastinal emphysema and bilateral pleural effusion became evident. An esophagogram followed by computed tomography showed an esophageal perforation caused by the blast injury, and we performed an esophagectomy with recontruction of the gastric tube. After the operation, an X-ray showed a foreign body in the lower abdomen, which we found in the upper thoracic esophagus on the day of injury. We surmised that the patient had inadvertently swallowed a foreign body, which had been heated and scattered by the explosion, and it had melted the upper thoracic esophagus.
authors.affiliation: Department of Surgery, Nagaoka Red-Cross Hospital, Nagaoka, Japan.
authors.forename: Shigeaki
authors.initials: S
authors.lastname: Sawada
authors.forename: Akio
authors.initials: A
authors.lastname: Kusama
authors.forename: Naohiro
authors.initials: N
authors.lastname: Shimakage
authors.forename: Tadashi
authors.initials: T
authors.lastname: Tanabe
authors.forename: Takanao
authors.initials: T
authors.lastname: Okamura
authors.forename: Katsuyuki
authors.initials: K
authors.lastname: Uchida
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Tsukada
authors.forename: Kenzo
authors.initials: K
authors.lastname: Tajima
mesh_terms: D001753:Blast Injuries / Q000175:diagnosis* / Q000000981:diagnostic imaging; D004939:Esophageal Perforation / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000209:etiology; D005107:Explosions; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D017132:Workplace