Closed injury of pharynx and neck esophagus
Introduction
Brief introduction of closed injury of pharynx and neck esophagus The closed pharyngeal and cervical esophageal closed injury (closedinjury ofpharynxandcervicalesophagus) is rare, often due to external force squeezed the pharyngeal cavity and cervical esophagus or pulled by strong traction. Because of the lack of characteristic performance, it is difficult to diagnose early in the clinic, and it is often caused by concurrent deep neck infection or mediastinal infection. X-ray and esophagography help determine the location of the injury. basic knowledge The proportion of illness: 0.075% Susceptible people: no special people Mode of infection: non-infectious Complications: mediastinal emphysema, pneumothorax, acute mediastinal inflammation
Cause
Causes of closed injury of the esophagus in the pharynx and neck
(1) Causes of the disease
There are three main factors that cause common pharyngeal and cervical esophageal occlusion injury: external force squeezes the air-containing pharyngeal cavity and cervical esophagus to cause tearing, high-pressure airflow impacts the pharynx and esophagus, and the esophagus is strongly pulled. The former often occurs in the neck blunt contusion, the latter two are common in endogenous injury.
(two) pathogenesis
1. The blunt trauma of the neck squeezes the air-containing pharyngeal cavity and the cervical esophagus, and the lumen is impacted on the hard cervical vertebrae, causing rupture or tear, especially when the cervical vertebrae have bone hyperplasia or there is a vertebral body in front. When the sharp bone spurs, the mucosa is more likely to be damaged and perforation occurs. When the neck is closed and the tongue is fractured, the posterior dislocation of the fracture piece can pierce the hypopharyngeal mucosa.
2. Endogenous injury High pressure airflow into the pharynx and esophagus, or the esophagus is strongly pulled, exceeding the elastic limit of the esophagus itself, can cause mucosal rupture, if the esophageal mucosa is original inflammation or ulcerative lesions, any cause esophagus Elevated internal pressure or strong traction can easily cause esophageal rupture, such as severe vomiting can cause the esophagus to rupture.
Prevention
Pharyngeal and cervical esophageal closed injury prevention
There are generally no special precautions.
Complication
Complications of pharyngeal and cervical esophageal closed injury Complications, mediastinal emphysema, pneumothorax, acute mediastinal inflammation
Closed lesions of the esophagus in the pharynx and neck are often complicated by mediastinal emphysema, pneumothorax, deep neck infection and mediastinal inflammation.
Symptom
Pharyngeal and cervical esophageal closed injury symptoms Common symptoms Dysphagia, difficulty breathing, subcutaneous emphysema, pneumothorax
1. Pain and dysphagia Local pain is very obvious, aggravation when swallowing, refuse to eat, even saliva can not swallow, pain in the posterior neck area indicates deep mediastinal inflammation, patients often fix the neck in a certain position due to pain, Do not dare to move, chest and esophageal injury pain is located behind the sternum and back.
2. Saliva with blood or hematemesis.
3. Subcutaneous emphysema and mediastinal emphysema are common signs of esophageal rupture.
4. Difficulty breathing and cyanosis are complicated by mediastinal emphysema, pneumothorax and mediastinal infection.
5. Infected lower pharynx or esophageal contusion perforation, saliva and food into the deep fascia of the neck, if not treated in time, deep neck infection and mediastinal inflammation will occur.
Examine
Examination of pharyngeal and cervical esophageal closed injury
1. X-ray inspection:
(1) Photograph: It can be seen that there is air shadow in the soft tissue of the neck; if there is infection, the posterior pharyngeal wall or mediastinum widening and tracheal displacement can be found.
(2) Esophageal angiography: The part showing the esophageal rupture.
2. Endoscopy: Understand the location and extent of the injury.
Diagnosis
Diagnosis and diagnosis of closed injury of esophagus in pharynx and neck
1. The patient has a history of external force extrusion, or causes an increase in pressure in the esophagus, or causes the esophagus to be strongly pulled.
2. Clinical manifestations of pharyngeal and esophageal pain, difficulty swallowing, saliva with blood or hematemesis with subcutaneous emphysema and mediastinal emphysema.
3. Auxiliary examination and diagnosis.
