Uso de colgajos musculares en las perforaciones traumáticas del esófago Use of muscular flaps to repair traumatic esophageal perforations. Report of two cases

Las perforaciones del esófago, especialmente las de manejo tardío, representan un dilema y un reto para el cirujano. El manejo de las perforaciones tardías ha sido controversial y las opciones terapéuticas incluyen desde manejo conservador y simple drenaje hasta la resección del esófago. Se presentan 2 casos de perforaciones esofágicas producidas por proyectil de arma de fuego referidos a los 28 y 8 días respectivamente. En ambos se realizó reparación primaria reforzada con colgajo muscular. The management of esophageal perforations is variable, ranging from conservative management to esophageal excision. Muscular flaps are used specially when there are associated lesions in trachea or aorta. We report two patients managed using this last technique. A 31 years old woman that received a gun shot in the neck that was operated, repairing two tracheal and two esophageal perforations. The patient had to be reoperated 28 days later, due to a dehiscence of the esophageal suture. A muscular flap was used to repair the lesion with a good postoperative evolution. A 17 years old male that received a gunshot in the left supraclavicular region. Eight days later, he was operated, draining a right empyema and repairing an esophageal perforation using a muscular flap. The patient had a good postoperative evolution.