挫傷所致食道穿孔—個案報告

Esophageal Perforation Caused by Blunt Trauma –A Case Report

一位40歲男性，職業為畜牧技術員，被一隻體重約100公斤的豬撞擊胸口後，出現間歇性之上腹痛，進食後疼痛感會加劇，有時伴隨輕微呼吸短促，經腹部電腦斷層及上消化道攝影檢查後，診斷食道破裂並接受手術治療。食道穿孔若能及早診斷，給予謹慎適宜的治療，可有效減少食道穿孔造成的併發症以及死亡率，但因食道穿孔初期症狀的非特異性，故不易早期診斷。非醫源性挫傷所致食道穿孔的案例很少，藉此病例及文獻回顧，整理挫傷所致食道穿孔的機轉、診斷與治療。

A 40-year-old male animal husbandry technician was hit on the chest wall by a pig weighted approximately 100 kilograms. Intermittent epigastric pain had been noted since the accident for days. Pain was aggravated after food intake and accompanied with mild dyspnea. After abdominal computed tomography and upper gastrointestinal series, esophageal rupture was highly suspected and operation was accordingly performed. Early diagnosis and appropriate treatment plan help reduce the complications and mortality of esophageal perforation. However, because of the initital presentation of nonspecific symptoms, early diagnosis of esophageal perforation is usually difficult. Esophageal perforation caused by non-iatrogenic blunt trauma is rare. We further discussed the mechanism, diagnosis and treatment of esophageal perforation caused by blunt trauma according to the case report and literature reviewed.