What are the guideline sources, guidelines and references for Traumatic esophageal injury ?
Guideline sources The following summarized guidelines for the evaluation and management of traumatic esophageal injury are prepared by our editorial team based on guidelines from the World Society of Emergency Surgery (WSES 2019). 1 Guidelines 1. Diagnostic investigations Physical examination: do not rely on physical examination as it is not reliable for early diagnosis of traumatic esophageal injury. D Laboratory studies: do not rely on laboratory studies as they are not useful for early diagnosis of traumatic esophageal injury. D Computed tomography: obtain contrast-enhanced CT and CT esophagography in hemodynamically stable patients with suspected traumatic esophageal injury. B 2. Diagnostic procedures Upper gastrointestinal endoscopy: perform flexible endoscopy as an adjunct to CT in patients with suspected traumatic esophageal injury. B https://web.pathway.md/diseases/recdOwwlXamIKimzK 1/2 6/24/23, 4:08 PM Traumatic esophageal injury Pathway 3. Nonpharmacologic interventions Indications for non-surgical management: Offer non-surgical management for patients with esophageal perforation if they meet the criteria for non-surgical management: delay in management of < 24 h absence of symptoms and signs of sepsis cervical or thoracic location of the esophageal perforation contained perforation by surrounding tissues (intramural; minimal peri-esophageal extravasation of contrast material with intra-esophageal drainage; absence of massive pleural contamination) no preexistent esophageal disease possibility of close surveillance by expert esophageal team availability of surgical and radiological skills all day and all night. B Offer non-surgical management for patient with traumatic esophageal injury only if intense monitoring in an ICU setting, surgical expertise and interventional radiology skills are available all day and all night. B 4. Surgical interventions Surgery: perform immediate surgery in patients with traumatic esophageal injury if they have hemodynamic instability, obvious non-contained extravasation of contrast material and systemic signs of severe sepsis. B Show 6 more References 1. Mircea Chirica, Michael D Kelly, Stefano Siboni et al. Esophageal emergencies: WSES guidelines. World J Emerg Surg. 2019 May 31;14 26. Open https://web.pathway.md/diseases/recdOwwlXamIKimzK 2/2