title: Western Trauma Association Critical Decisions in Trauma: Diagnosis and management of esophageal injuries.
abstract: This is a recommended management algorithm from the Western Trauma Association addressing the diagnostic evaluation and management of esophageal injuries in adult patients. Because there is a paucity of published prospective randomized clinical trials that have generated Class I data, the recommendations herein are based primarily on published observational studies and expert opinion of Western Trauma Association members. The algorithms and accompanying comments represent a safe and sensible approach that can be followed at most trauma centers. We recognize that there will be patient, personnel, institutional, and situational factors that may warrant or require deviation from the recommended algorithm. We encourage institutions to use this guideline to formulate their own local protocols.The algorithm contains letters at decision points; the corresponding paragraphs in the text elaborate on the thought process and cite pertinent literature. The annotated algorithm is intended to (a) serve as a quick bedside reference for clinicians; (b) foster more detailed patient care protocols that will allow for prospective data collection and analysis to identify best practices; and (c) generate research projects to answer specific questions concerning decision making in the management of adults with esophageal injuries.
authors.affiliation: From the Departments of Surgery (W.L.B., E.E.M.), Denver Health Medical Center, Denver, Colorado; Indiana University School of Medicine (D.V.F.), Indianapolis, Indiana; University of Oklahoma School of Medicine (R.A.A.), Oklahoma City, Oklahoma; University of Tennessee-Memphis Health Sciences Center (M.C.), Memphis, Tennessee; Legacy Emanuel Medical Center(R.K.-J.), Portland, Oregon; University of Miami School of Medicine (N.N.), Miami, Florida; Oregon Health Sciences University (S.R., M.S., K.B.), Portland, Oregon; University of California-Davis (D.V.S.), Sacramento, California.
authors.forename: Walter L
authors.initials: WL
authors.lastname: Biffl
authors.forename: Ernest E
authors.initials: EE
authors.lastname: Moore
authors.forename: David V
authors.initials: DV
authors.lastname: Feliciano
authors.forename: Roxie A
authors.initials: RA
authors.lastname: Albrecht
authors.forename: Martin
authors.initials: M
authors.lastname: Croce
authors.forename: Riyad
authors.initials: R
authors.lastname: Karmy-Jones
authors.forename: Nicholas
authors.initials: N
authors.lastname: Namias
authors.forename: Susan
authors.initials: S
authors.lastname: Rowell
authors.forename: Martin
authors.initials: M
authors.lastname: Schreiber
authors.forename: David V
authors.initials: DV
authors.lastname: Shatz
authors.forename: Karen
authors.initials: K
authors.lastname: Brasel
mesh_terms: D000328:Adult; D000465:Algorithms; D003661:Decision Support Techniques; D004947:Esophagus / Q000293:injuries*; D006801:Humans; D014947:Wounds and Injuries / Q000175:diagnosis* / Q000601:surgery*