Resumos
O tratamento dos ferimentos de hipofaringe ainda é controvertido na literatura. A maior parte dos autores acredita que o tratamento preferencial consiste na exploração cirúrgica imediata, com reparo primário da lesão e drenagem ou somente a drenagem, e que o tratamento conservador estaria indicado em casos selecionados. Entre 157 ferimentos cervicais penetrantes, num período de quatro anos, encontramos sete (4,4%) casos de perfuração de hipofaringe. Destes, seis (85,7%) foram tratados cirurgicamente, cinco (71 ,4%) com sutura primária e drenagem. A taxa de mortalidade foi nula e a morbidade foi de 28,6%, sendo de 11,2 dias o tempo médio de internação.
Trauma; Faringe
Hypopharyngeal perforation in penetrating cervical trauma occurs rarely. The treatment of hypopharyngeal wounds is controversial. The mainstay in treatment according to the majority of authors is immediate surgical exploration with primary repair of the lesion and drainage or only drainage. Conservative treatment would be indicated only in selected cases. The authors studied 157 penetrating cervical wounds in four years period and found seven (4.4%) cases with hypopharyngeal perforation. There were male patients from 18 to 45 years old. Five injuries (71.4%) were stab wounds and two of them (28.6%) were caused by gunshot. Only one patient had jugular vein associated injury. Six patients (85.7%) were treated surgically, five (71.4%) with primary suture and drainage. The mortality rate was null and morbidity was 28.6%, mean hospital stay was 11.2 days.
Trauma; Pharynx
ARTIGOS ORIGINAIS
Ferimento de hipofaringe no trauma cervical penetrante
Hypopharyngeal injuries in penetrating neck trauma
Paulo Roberto Corsi, TCBC-SPI; Rafael Carrieri Neto, ACBC-SPII; Samir Rasslan, TCBC-SPIII
IProfessor Assistente do Departamento de Cirurgia
IIResidente do Departamento de Cirurgia
IIIProfessor Titular e Diretor do Serviço de Emergência
Endereço para correspondência Endereço para correspondência: Dr. Paulo Roberto Corsi Rua Joaquim Antunes, 577/132 05415-011 - São Paulo - SP
RESUMO
O tratamento dos ferimentos de hipofaringe ainda é controvertido na literatura. A maior parte dos autores acredita que o tratamento preferencial consiste na exploração cirúrgica imediata, com reparo primário da lesão e drenagem ou somente a drenagem, e que o tratamento conservador estaria indicado em casos selecionados. Entre 157 ferimentos cervicais penetrantes, num período de quatro anos, encontramos sete (4,4%) casos de perfuração de hipofaringe. Destes, seis (85,7%) foram tratados cirurgicamente, cinco (71 ,4%) com sutura primária e drenagem. A taxa de mortalidade foi nula e a morbidade foi de 28,6%, sendo de 11,2 dias o tempo médio de internação.
Unitermos: Trauma; Faringe.
ABSTRACT
Hypopharyngeal perforation in penetrating cervical trauma occurs rarely. The treatment of hypopharyngeal wounds is controversial. The mainstay in treatment according to the majority of authors is immediate surgical exploration with primary repair of the lesion and drainage or only drainage. Conservative treatment would be indicated only in selected cases. The authors studied 157 penetrating cervical wounds in four years period and found seven (4.4%) cases with hypopharyngeal perforation. There were male patients from 18 to 45 years old. Five injuries (71.4%) were stab wounds and two of them (28.6%) were caused by gunshot. Only one patient had jugular vein associated injury. Six patients (85.7%) were treated surgically, five (71.4%) with primary suture and drainage. The mortality rate was null and morbidity was 28.6%, mean hospital stay was 11.2 days.
Key words: Trauma; Pharynx.
Texto completo disponível apenas em PDF.
Full text available only in PDF format.
Recebido em 3/3/97
Aceito para publicação em 14/8/97
Trabalho realizado no Serviço de Emergência do Departamento de Cirurgia da Faculdade de Ciências Médicas da Santa Casa de São Paulo.
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8Hatzitheofilou C, Strahlendorf C, Kakoyiannis S, et al. Penetrating external injuries of the oesophagus and pharynx. Br J Surg 1993; 80: 1.147-9.
- 9. Levine PA. Hypopharyngeal perforation. Arch Otolaryngol 1980; 106: 578-80.
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Endereço para correspondência:
Datas de Publicação
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Publicação nesta coleção
26 Jul 2010 -
Data do Fascículo
Fev 1998
Histórico
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Recebido
03 Mar 1997 -
Aceito
14 Ago 1997