Unique case of esophageal rupture after a fall from height

We describe a unique case of a 23 year old woman that presented at our trauma resuscitation room after a fall from 8 meters. During physical examination there were no clinical signs of life-threatening injuries. She did however have a massive amount of subcutaneous emphysema of the chest and neck and pneumomediastinum. Flexible laryngoscopy revealed a lesion in the upper esophagus just below the level of the upper esophageal sphincter. Despite preventive administration of intravenous antibiotics and nutrition via a nasogastric tube, the patient developed a cervical abscess, which drained spontaneously. Normal diet was gradually resumed after 2.5 weeks and the patient was discharged in a reasonable condition 3 weeks after the accident.This case report presents a high cervical esophageal rupture without associated local injuries after a fall from height.Esophageal rupture due to external trauma was first described in 1936 by Vinson[1]. Traumatic ruptures of the esophagus represent 4-14% of all esophageal perforations[2,3]. Penetrating or iatrogenic trauma (during endoscopy or operation) are the most frequent causes of rupture of the esophagus[4]. Ruptures of the esophagus due to blunt trauma are very rare and are estimated to occur in less than 1% of patients experiencing blunt (cervical) trauma[4]. We present a rare case of cervical esophageal rupture after a high energy trauma due to a fall from the third floor of a building.A 23 year old woman presented at our trauma resuscitation room after a fall from 8 meters. During physical examination (ATLS？ protocol) there were no clinical signs of life-threatening injuries. Neurological examination did not reveal any abnormalities either. She did however have a large amount of subcutaneous emphysema of the chest and neck and complained of low back pain. Plain X-rays of the chest confirmed the subcutaneous emphysema of the chest and revealed a pneumomediastinum without signs of pneumothoraces (Figure 1). Due to the massive a