Non Operative Management of Post-Traumatic Esophageal Perforation in Children: A Case Report

Cervical esophageal perforation in children is generally less severe than thoracic or abdominal perforations, with slower spread to the mediastinum due to anatomical barriers. Common symptoms include neck pain, dysphagia, dysphonia, and subcutaneous emphysema, which is present in approximately 95% of cases. Diagnosis primarily relies on contrast-enhanced CT, which is the most sensitive modality (92–100%) and provides valuable information on disease extent and complications. Contrast esophagography remains the gold standard, with water-soluble agents like Gastrografin preferred initially. Standard radiographs may reveal prevertebral air or other signs, but early imaging can be falsely negative. Management depends on the severity and location. Nonoperative treatment may be appropriate for small, contained, iatrogenic perforations. Early-detected cases may be treated with endoscopic clipping. Surgical intervention, typically via left cervicotomy with primary repair and drainage, is reserved for more extensive or complicated cases. We present a case of cervical perforation of the esophagus in a 7 years old patient.