title: T-tube placement as a method for treating penetrating oesophageal injuries.
abstract: BACKGROUND
  Penetrating oesophageal injuries are extremely rare. Their timely recognition can be difficult and optimal treatment remains controversial. Early recognition of injury is possible with the help of a high index of suspicion and early radiological and endoscopic examinations. Prompt surgical intervention with primary repair of injury, should be the goal.
  
  
  METHODS
  We describe two cases of penetrating oesophageal trauma where T-Tube placement through the oesophageal defect, was successfully employed. Both cases proved to be challenging due to time lapse after injury and anatomical location.
  
  
  CONCLUSIONS
  Penetrating injuries to the Oesophagus are rare with a reported incidence of 11-17%, most are due to gunshot injuries or stabbings, cervical followed by the thoracic Oesophagus are most at risk. In delayed presentations and sepsis related multi-organ instability, diversion and drainage are considered appropriate. T-tube placement through defects in difficult situations of delayed presentation is well described in setting of iatrogenic perforations. Their use has been described in penetrating injuries but much less frequently.
  
  
  CONCLUSIONS
  T-tube placement though oesophageal defects can prove to be an effective treatment option to repair both iatrogenic and penetrating injuries of the Oesophagus, whether early or delayed.
authors.affiliation: Aga Khan University Hospital, Karachi, Pakistan. Electronic address: roger.gill@aku.edu.
authors.forename: Roger Christopher
authors.initials: RC
authors.lastname: Gill
authors.affiliation: Aga Khan University Hospital, Karachi, Pakistan. Electronic address: Inam.pal@aku.edu.
authors.forename: K M Inam
authors.initials: KMI
authors.lastname: Pal
authors.affiliation: Aga Khan University Hospital, Karachi, Pakistan. Electronic address: fmannan90@gmail.com.
authors.forename: Fatima
authors.initials: F
authors.lastname: Mannan
authors.affiliation: Aga Khan University Hospital, Karachi, Pakistan. Electronic address: mberbawa@hotmail.com.
authors.forename: Amber
authors.initials: A
authors.lastname: Bawa
authors.affiliation: Aga Khan University Hospital, Karachi, Pakistan. Electronic address: saulat.fatimi@aku.edu.
authors.forename: Saulat H
authors.initials: SH
authors.lastname: Fatimi
keywords: Penetrating Oesophageal injuries; T-Tube