ABSTRACT

Background: Penetrating neck injuries represent 5-10% of all trauma lesions that present to the emergency room resulting in significant mortality. Case report: 34-year-old male is brought to the emergency room with a gunshot wound in the neck. Urgent endotracheal intubation was performed and then referred to the operating room. We performed a transverse cervical incision observing both, esophageal and tracheal lesions comprising the third and fourth tracheal rings. A tracheostomy tube was put in place through the anterior tracheal lesion. Debridement of the borders and primary closure of the esophageal lesion was carried out in order to place a vascularized sternothyroid muscle flap between the tracheal and esophageal injuries. A drain is placed and gastrostomy is performed. Enteral nutrition via gastrostomy was indicated for ten days. Oral intake was reinstituted afterwards without evidence of leakage. Conclusion: A vascularized muscle flap, involving the sternocleidomastoid or infrahyoid muscles, is critical to protect the esophageal repair and reduce the incidence of tracheoesophageal fistulas and leakage.

KEYWORDS

Neck injuries, tracheal injuries, esophagus injuries, muscle patch.

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