Penetrating aerodigestive injuries and the role of computed tomography esophagography

IF 2.7 3区医学 Q1 SURGERY

American journal of surgery Pub Date : 2025-01-01 DOI:10.1016/j.amjsurg.2024.116061

Lillian Malach, Saskya Byerly , Cory R. Evans, James Babowice, Tyler Holliday, Emily K. Lenart, Sara Soule, Andrew J. Kerwin, Dina M. Filiberto

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引用次数: 0

Abstract

Background

Penetrating neck injuries can be fatal if not quickly identified; however, operative intervention is not always necessary. Prompt evaluation with imaging studies aids in identifying patients who need intervention.

Methods

A retrospective, single-center study of patients with PNI from 2017 to 2022 was performed. Management, outcomes, and mortality were compared. Sensitivity and specificity were calculated for imaging studies performed.

Results

Of 436 patients with PNI, 72 had an aerodigestive injury: 42(58 %) underwent operative management, and 30(42 %) underwent nonoperative management. There was no difference in mortality. The sensitivity and specificity of computed tomography (CT) esophagography for hypopharyngeal/esophageal injury were 100 %. The sensitivity and specificity of fluoroscopic esophagography were 71 % and 99 %. The sensitivity and specificity of combined fluoroscopic esophagography and flexible esophagoscopy were 100 %.

Conclusion

In select patients with penetrating aerodigestive injuries, nonoperative management is safe. CT esophagography alone may be sufficient to identify a hypopharyngeal/esophageal injury.

查看原文本刊更多论文

穿透性消化道损伤和计算机断层扫描食道造影的作用。

背景：颈部穿透性损伤如果不能迅速识别，可能会致命；但手术干预并非总是必要的。通过影像学检查进行及时评估有助于识别需要干预的患者：对 2017 年至 2022 年的 PNI 患者进行了一项回顾性单中心研究。比较了管理、结果和死亡率。计算了所进行的成像研究的敏感性和特异性：在436例PNI患者中，72例有气道损伤：42人（58%）接受了手术治疗，30人（42%）接受了非手术治疗。死亡率没有差异。计算机断层扫描（CT）食道造影术对下咽/食道损伤的敏感性和特异性均为 100%。透视食管造影的敏感性和特异性分别为 71% 和 99%。综合透视食管造影和柔性食管镜检查的敏感性和特异性均为 100%：结论：对于特定的穿透性消化道损伤患者，非手术治疗是安全的。结论：对于特定的气道穿透性损伤患者，非手术治疗是安全的。仅 CT 食管造影就足以鉴别下咽/食管损伤。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

American journal of surgery 医学-外科

CiteScore

5.00

自引率

6.70%

发文量

570

审稿时长

56 days

期刊介绍： The American Journal of Surgery® is a peer-reviewed journal designed for the general surgeon who performs abdominal, cancer, vascular, head and neck, breast, colorectal, and other forms of surgery. AJS is the official journal of 7 major surgical societies* and publishes their official papers as well as independently submitted clinical studies, editorials, reviews, brief reports, correspondence and book reviews.