• Mauricio Millán, Michael W Parra, Boris Sanchez-Restrepo, Yaset Caicedo, Carlos Serna, Adolfo González-Hadad, Luis Fernando Pino, Mario Alain Herrera, Fabian Hernández, Fernando Rodríguez-Holguín, Alexander Salcedo, José Julián Serna, Alberto García, and Carlos A Ordoñez.
• Fundación Valle del Lili, Department of Surgery, Division of Transplant Surgery, Cali, Colombia.
• Colomb Medica. 2021 Apr 1; 52 (2): e4094806.

AbstractEsophageal trauma is a rare but life-threatening event associated with high morbidity and mortality. An inadvertent esophageal perforation can rapidly contaminate the neck, mediastinum, pleural space, or abdominal cavity, resulting in sepsis or septic shock. Higher complications and mortality rates are commonly associated with adjacent organ injuries and/or delays in diagnosis or definitive management. This article aims to delineate the experience obtained by the Trauma and Emergency Surgery Group (CTE) of Cali, Colombia, on the surgical management of esophageal trauma following damage control principles. Esophageal injuries should always be suspected in thoracoabdominal or cervical trauma when the trajectory or mechanism suggests so. Hemodynamically stable patients should be radiologically evaluated before a surgical correction, ideally with computed tomography of the neck, chest, and abdomen. While hemodynamically unstable patients should be immediately transferred to the operating room for direct surgical control. A primary repair is the surgical management of choice in all esophageal injuries, along with endoscopic nasogastric tube placement and immediate postoperative care in the intensive care unit. We propose an easy-to-follow surgical management algorithm that sticks to the philosophy of "Less is Better" by avoiding esophagostomas.Copyright © 2021 Colombia Medica.

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