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complications and month-long hospitalizations, both patients References
made full recoveries without apparent long-term complica- 1. Schmidt SC, Strauch S, Rosch T, et al. Management of esoph-
tions. 12,13 Other case reports also described explosion-related ageal perforations. Surg Endosc. 2010;24(11):2809–2813. doi:
injury but involved an explosion related to a carbonated drink 10.1007/s00464-010-1054-6
and a foreign body ingestion heated by an explosion, leading 2. Eroglu A, Can Kurkcuoglu I, Karaoganogu N, Tekinbas C, Yimaz
O, Basog M. Esophageal perforation: the importance of early di-
to esophageal necrosis, which differed significantly from the agnosis and primary repair. Dis Esophagus. 2004;17(1):91–94.
blunt trauma in our case. 14,15 doi:10.1111/j.1442-2050.2004.00382.x
3. Sdralis E, Petousis S, Rashid F, Lorenzi B, Charalabopoulos A.
Unlike most of these cases, which were managed surgically, Epidemiology, diagnosis, and management of esophageal perfo-
our case adds to the literature by demonstrating successful rations: systematic review. Dis Esophagus. 2017;30(8):1–6. doi:
10.1093/dote/dox013
management using endoscopic stenting. This highlights the 4. Zwischenberger JB, Savage C, Bidani A. Surgical aspects of
evolving treatment options for traumatic esophageal per- esophageal disease: perforation and caustic injury. Am J Respir
forations, using a minimally invasive technique. The unique Crit Care Med. 2002;165(8):1037–1040. doi:10.1164/ajrccm.
mechanism of injury and the emphasis on minimally inva- 165.8.2104105
sive treatment in our case offer an addition to the body of 5. Aiolfi A, Inaba K, Recinos G, Khor D, et al. Non-iatrogenic esoph-
literature on esophageal perforations, especially given that the ageal injury: a retrospective analysis from the National Trauma
initial presentation of esophageal perforation can often be am- Data Bank. World J Emerg Surg. 2017;12:19. doi:10.1186/
s13017-017-0131-8
biguous, particularly in the context of concomitant injuries. 6. Kuppusamy MK, Hubka M, Felisky C, et al. Evolving manage-
Practitioners should therefore retain a high degree of suspicion ment strategies in esophageal perforation: surgeons using non-
in such cases, especially when the mechanism of injury is an operative techniques to improve outcomes. J Am Coll Surg.
explosion. 7–9 2011;213(1):164–171; discussion 171–172. doi:10.1016/j.jamcoll
surg.2011.01.059
7. Fonseca AZ, Ribeiro MA Jr, Frazão M, Costas MC, Spinelli L,
Conclusion Contrucci O. Esophagectomy for a traumatic esophageal perfo-
ration with delayed diagnosis. World J Gastrointest Surg. 2009;1
This case has significant implications for military medicine, (1):65–67. doi:10.4240/wjgs.v1.i1.65. PMID: 21160799
where traumatic injuries, including esophageal perforations, 8. Champion HR, Holcomb JB, Young LA. Injuries from explosions:
are more common. These injuries often occur in austere en- physics, biophysics, pathology and required research focus. J
16
vironments, making timely and effective management crucial. Trauma. 2009; 66 (5):1468–1477; discussion 1477. doi:10.1097/
The initial response to traumatic esophageal perforations in TA.0b013e3181a27e7f
military settings must prioritize rapid stabilization and trans- 9. Puerta Vicente A, Priego Jiménez P, Cornejo López MÁ, et al.
Management of esophageal perforation: 28-year experience in a
port to higher-level care facilities. Field medics and military major referral center. Am Surg. 2018;84(5):684–689.
surgeons need to recognize the signs of esophageal perforation 10. Russo F, Ravindranath A, Wang H, et al. Management of esoph-
and initiate appropriate interventions with limited resources. ageal perforations in the 21st century: a narrative review of the
Advanced imaging technologies and minimally invasive tech- literature. J Thorac Dis. 2018;10(Suppl 26).
niques, such as endoscopic stenting, will likely not be available 11. Abbas G, Schuchert MJ, Pettiford BL, et al. Contemporaneous
in these scenarios. Operative intervention will be required, management of esophageal perforation. Surgery. 2009;146(4):
5
749–756. doi:10.1016/j.surg.2009.06.058
mandating that deployed surgeons understand how to repair 12. Guth AA, Gouge TH, Depan HJ. Blast injury to the thoracic
these injuries, as the esophagus courses from the oropharynx esophagus. Ann Thorac Surg. 1991;51(5):837–839. doi:10.1016/
to the stomach. Maintaining a high degree of suspicion for 0003-4975(91)90147-i
patients presenting with explosive injuries, especially in the 13. Roan JN, Wu MH. Esophageal perforation caused by exter-
military setting is essential to improving outcomes. nal air-blast injury. J Cardiothorac Surg. 2010;5:130. doi:10.
1186/1749-8090-5-130
14. Park JB, Hwang JJ, Bang SH, et al. Barotraumatic esophageal
Author Contributions perforation by explosion of a carbonated drink bottle. Ann Tho-
SCF wrote the first draft. EWB, MM, and JBH edited and re- rac Surg. 2012;93(1):315–316. doi:10.1016/j.athoracsur.2011.
viewed subsequent drafts. MFG, JMD, and AMA provided 06.071
patient-specific insight and expertise in respective fields. All 15. Sawada S, Shimizu N, Kawahara K, et al. Esophageal rupture
authors read and approved the final manuscript. caused by blast injury. J Trauma. 1986;26:479–481.
16. Mubang RN, Sigmon DF, Stawicki SP. Esophageal Trauma. In:
StatPearls. Updated July 25, 2023. StatPearls Publishing; 2025.
Disclosures Accessed August 4, 2025. https://www.ncbi.nlm.nih.gov/books/
The authors have no conflict of interest to disclose. NBK470161/
Funding PMID: 40986755; DOI: 10.55460/DC5Q-F42E
No funding was received for this work.
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