oesageal and tarcheal injuries

Question 1

symptoms that could lead to oepsageal injury

Answer 1

dyshpagia
odonophagia
hematemesis, hemoptysis, hoarseness,

Question 2

physical exam findings of oespageal injuries

Answer 2

subcutanoeus emphysema , neck hematoma, and neck tenderness.

Question 3

what do you call air in the mediatsitum

Answer 3

pneumomediatsinum

Question 4

hammans sign

and where do we see it

Answer 4

crunching, rasping sound, synchronous with the heartbeat, heard over the precordium in spontaneous mediastinal emphysema. the sound is similar to crackles that you would hear

• boerheaves

Question 5

what can cause a pneumomediastinum

Answer 5

injury to the esophagus
injury to the trachea
iatrogenic - endoscopic, Intubuation

Question 6

Boerhaave syndrome

Answer 6

uncommon but life-threatening condition causes by a full thickness rupture of the oesophagus.

Question 7

rf Boerhaave syndrome

Answer 7

middle aged alcoholic men after repeating vomiting

Question 8

presentaiton o fboerheaves

Answer 8

Severe tearing chest pain worse on swallowing
Little/no haematemsis
Signs of shock
Subcutaneous emphysema
Pneumomediastinum, pleural effusions, pneumothorax on x-ray

Question 9

in boerheaves what should be avoided

Answer 9

OGD- you can worsen the perforation

Question 10

managemtn of boerheaves

Answer 10

IV fluid resuscitation
IV antibiotics to cover/treat mediastinitis
Surgical correction

mortality is high

Question 11

x ray signs of a pneumoediatinum

Answer 11

double eheart border?
widening of the mediastinum
pneumothorax- air is getting everywhere

Question 12

def of pneumomediatsiumm

Answer 12

Pneumomediastinum is the presence of extraluminal gas within the mediastinum. Gas may originate from the lungs, trachea, central bronchi, oesophagus, and peritoneal cavity and track from the mediastinum to the neck or abdomen.
( so its vice versa) hence why in laprsocopic surgery a complication is a pneumomediastinum because you indeuce a pneumoperitoneum and this can track to the mediatsimym.

Question 13

overt pneumomediastimum

occult pneumomediastinum

Answer 13

if pneumomediastinum is visible on chest x-ray it is termed overt pneumomediastinum whereas if it is only visible on CT then it is termed occult pneumomediastinum 8.

Question 14

what can cause oespagea perforation

Answer 14

boerhaeves
endoscoppic
oesophageal carcinoma

Question 15

how can we injurt he tracheobronecheal tree

Answer 15

bronchosocpy
trachestomy
ET intubatioon

Question 16

does pnemomediatnum always need a cause

Answer 16

Although it is rare, pneumomediastinum can occur spontaneously. This is considered benign and generally affects young adult males 9,10.

Question 17

tx of pneumomediastimum

Answer 17

Most pneumomediastinum requires no treatment, with the air being gradually absorbed on the following days.

Tension pneumomediastinum can be fatal and usually requires intervention with insertion of drains through the anterior thoracic wall aiming decompression

Question 18

mallory weiss vs boerheves

Answer 18

mw:mpartial thickenss tear so heamatomesis s

boerheves _ full thickness PERFORATION (not so much/veryy little hmatomesis )

Question 19

macklers triad

Answer 19

vommiting
chest pain
s.c emphyesema

Question 20

why is tracheal injury so dangerous and mortality

Answer 20

The trachea is near the esophagus, vagus nerve, recurrent laryngeal nerves, thyroid, carotid arteries, jugular veins, innominate arteries and veins, the pulmonary trunk, the azygos vein, and the aorta with the vertebra and spinal cord posteriorly.[

Question 21

Tracheal trauma may follow from either cervical or thoracic injury; cervical injuries tend to be more visible and obvious; thoracic injury may go unnoticed.

Question 22

how does inhaltion cause damge to trachea

Answer 22

inhalation and aspiration cause damage to the mucosal lining of the trachea, leading to inflammation, ulceration, and softening of the cartilaginous portions