{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T15:05:20Z","timestamp":1790175920246,"version":"4.1.0"},"reference-count":27,"publisher":"AOSIS","issue":"1","license":[{"start":{"date-parts":[[2024,9,9]],"date-time":"2024-09-09T00:00:00Z","timestamp":1725840000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:p>Background:\u00a0Timely detection of oesophageal injuries post-penetrating neck trauma is imperative because of the associated high morbidity and mortality. Patients commonly undergo both CT angiography (CTA) and contrast swallow studies (fluoroscopic oesophagography) when oesophageal injury is suspected.\n\nObjectives:\u00a0To determine the radiological findings of oesophageal injury after penetrating neck trauma comparing CTA and fluoroscopic oesophagography at a single tertiary centre.\n\nMethod:\u00a0The study retrospectively reviewed the data from CTA and fluoroscopic oesophagography reports of patients suspected of oesophageal injuries secondary to penetrating neck trauma at a tertiary hospital in South Africa from January 2018 to December 2022.\n\nResults:\u00a0A total of 76 records were reviewed. The mean age for the participants was 31.5 years, ranging from 0.75\u201366 years. In this study 6\/76 (8%) patients had confirmed oesophageal injury on fluoroscopy, which is considered the gold standard. The majority of penetrating neck injuries were in the 20\u201329 year age group, with 33\/76 (43%) injuries. Stab wounds as the mechanism of injury accounted for 57\/76 (75%). Dysphagia was experienced by 10\/76 (13%) of those who had injuries. Zone I injuries accounted for 33\/76 (43%) of the injuries.\n\nConclusion:\u00a0The incidence of oesophageal injuries secondary to penetrating neck injuries is comparable to previous studies. This study determined that CTA has a high sensitivity but low specificity.\n\nContribution:\u00a0Fluoroscopic oesophagography should, therefore, be performed in patients who have an abnormal CTA coupled with clinical signs and symptoms of oesophageal injury.<\/jats:p>","DOI":"10.4102\/sajr.v28i1.2930","type":"journal-article","created":{"date-parts":[[2024,9,9]],"date-time":"2024-09-09T07:43:15Z","timestamp":1725867795000},"update-policy":"https:\/\/doi.org\/10.4102\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Retrospective study of detecting oesophageal injuries post neck trauma: CTA versus fluoroscopy"],"prefix":"10.4102","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-6395-1318","authenticated-orcid":false,"given":"Audrey R.","family":"Rumhumha","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03rp50x72","id-type":"ROR","asserted-by":"publisher"}],"name":"University of the Witwatersrand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3522-6643","authenticated-orcid":false,"given":"Nicholas","family":"Christofides","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03rp50x72","id-type":"ROR","asserted-by":"publisher"}],"name":"University of the Witwatersrand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-1138-4978","authenticated-orcid":false,"given":"Pravani","family":"Moodley","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03rp50x72","id-type":"ROR","asserted-by":"publisher"}],"name":"University of the Witwatersrand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2580","published-online":{"date-parts":[[2024,9,9]]},"reference":[{"key":"ref0","doi-asserted-by":"crossref","unstructured":"Bodanapally UK, Shanmuganathan K, Dreizin D, et al. Penetrating aerodigestive injuries in the neck: A proposed CT-aided modified selective management algorithm. Eur Radiol. 2016;26(7):2409\u20132417. https:\/\/doi.org\/10.1007\/s00330-015-4050-3","DOI":"10.1007\/s00330-015-4050-3"},{"key":"ref1","doi-asserted-by":"crossref","unstructured":"Biancari F, D\u2019Andrea V, Paone R, et al. Current treatment and outcome of esophageal perforations in adults: Systematic review and meta-analysis of 75 studies. World J Surg 2013;37(5):1051\u20131059. https:\/\/doi.org\/10.1007\/s00268-013-1951-7","DOI":"10.1007\/s00268-013-1951-7"},{"key":"ref2","doi-asserted-by":"crossref","unstructured":"Antonowicz S, Maynard N. Oesophageal injury. Surgery. 2017;35(11):644\u2013648. https:\/\/doi.org\/10.1016\/j.mpsur.2017.09.003","DOI":"10.1016\/j.mpsur.2017.09.003"},{"key":"ref3","doi-asserted-by":"crossref","unstructured":"Norton-Gregory AA, Kulkarni NM, O\u2019connor SD, et al. CT esophagography for evaluation of esophageal perforation. Radiographics. 2021;41(2):447\u2013461. https:\/\/doi.org\/10.1148\/rg.2021200132","DOI":"10.1148\/rg.2021200132"},{"key":"ref4","unstructured":"Muckart DJJ. Trauma \u2013 The malignant epidemic. S Afr Med J. 1999;79:93\u201395."},{"key":"ref5","doi-asserted-by":"crossref","unstructured":"Bowley DM, Degiannis E, Goosen J, Boffard KD. Penetrating vascular trauma in Johannesburg, South Africa. Surg Clin North Am. 2002;82(1):221\u2013235. https:\/\/doi.org\/10.1016\/S0039-6109(03)00151-8","DOI":"10.1016\/S0039-6109(03)00151-8"},{"key":"ref6","doi-asserted-by":"crossref","unstructured":"Scholtz P, Beningfield S, Candy S. A retrospective study of computed tomography angiography versus digital subtraction angiography in penetrating neck trauma at Groote Schuur Hospital, South Africa. S Afr J Rad. 2014;18(1):601. https:\/\/doi.org\/10.4102\/sajr.v18i1.601","DOI":"10.4102\/sajr.v18i1.601"},{"key":"ref7","doi-asserted-by":"crossref","unstructured":"Saito N, Hito R, Burke PA, Sakai O. Imaging of penetrating injuries of the head and neck: Current practice at a level I trauma center in the United States. Keio J Med. 2014;63(2):23\u201333. https:\/\/doi.org\/10.2302\/kjm.2013-0009-RE","DOI":"10.2302\/kjm.2013-0009-RE"},{"key":"ref8","doi-asserted-by":"crossref","unstructured":"Madsen AS, Laing GL, Bruce JL, Clarke DL. A comparative audit of gunshot wounds and stab wounds to the neck in a South African metropolitan trauma service. Ann R Coll Surg Engl. 2016;98(7):488\u2013495. https:\/\/doi.org\/10.1308\/rcsann.2016.0181","DOI":"10.1308\/rcsann.2016.0181"},{"key":"ref9","doi-asserted-by":"crossref","unstructured":"Xu A, Breeze JL, Paulus JK, Bugaev N. Epidemiology of traumatic esophageal injury. Am Surg. 2019;85(4):342\u2013349. https:\/\/doi.org\/10.1177\/000313481908500422","DOI":"10.1177\/000313481908500422"},{"key":"ref10","doi-asserted-by":"crossref","unstructured":"Inaba K, Branco BC, Menaker J, et al. Evaluation of multidetector computed tomography for penetrating neck injury: A prospective multicenter study. J Trauma Acute Care Surg. 2012;72(3):576\u2013584. https:\/\/doi.org\/10.1097\/TA.0b013e31824badf7","DOI":"10.1097\/TA.0b013e31824badf7"},{"key":"ref11","doi-asserted-by":"crossref","unstructured":"Steenburg SD, Sliker CW, Shanmuganathan K, Siegel EL. Imaging evaluation of penetrating neck injuries. Radiographics. 2010;30(4):869\u2013886. https:\/\/doi.org\/10.1148\/rg.304105022","DOI":"10.1148\/rg.304105022"},{"key":"ref12","unstructured":"Maritz JPB, Bagadia A, Lubbe JA. Can computed tomographic angiography accurately exclude digestive tract injury after penetrating cervical trauma? S Afr J Surg. 2020;58(4):192\u2013198."},{"key":"ref13","doi-asserted-by":"crossref","unstructured":"Gambhir S, Swentek L, Maithel S, et al. Esophageal trauma: Analysis of incidence, morbidity, and mortality. Am Surg. 2019;85(10):1134\u20131138. https:\/\/doi.org\/10.1177\/000313481908501012","DOI":"10.1177\/000313481908501012"},{"key":"ref14","doi-asserted-by":"crossref","unstructured":"Levy AD, Carucci LR, Bartel TB, et al. ACR Appropriateness criteria dysphagia. J Am Coll Radiol. 2019;16(5):104\u2013115.","DOI":"10.1016\/j.jacr.2019.02.007"},{"key":"ref15","doi-asserted-by":"crossref","unstructured":"Wei CJ, Levenson RB, Lee KS. Diagnostic utility of CT and fluoroscopic esophagography for suspected esophageal perforation in the emergency department. Am J Roentgenol. 2020;215(3):631\u2013638. https:\/\/doi.org\/10.2214\/AJR.19.22166","DOI":"10.2214\/AJR.19.22166"},{"key":"ref16","doi-asserted-by":"crossref","unstructured":"Bell RB, Osborn T, Dierks EJ, et al. Management of penetrating neck injuries: A new paradigm for civilian trauma. J Oral Maxillofac Surg. 2007;65(4):691\u2013705.","DOI":"10.1016\/j.joms.2006.04.044"},{"key":"ref17","doi-asserted-by":"crossref","unstructured":"Salehpoor Ali, Shiehmorteza M, Terrazas M, Thompson M. Imaging in the evaluation of esophageal trauma including surgery. Contemp Diagn Radiol. 2022;45(16):1\u20137. https:\/\/doi.org\/10.1097\/01.CDR.0000852912.71335.90","DOI":"10.1097\/01.CDR.0000852912.71335.90"},{"key":"ref18","doi-asserted-by":"crossref","unstructured":"Sudarshan M, Cassivi SD. Management of traumatic esophageal injuries. J Thorac Dis. 2019;11(Suppl 2):172\u2013176. https:\/\/doi.org\/10.21037\/jtd.2018.10.86","DOI":"10.21037\/jtd.2018.10.86"},{"key":"ref19","doi-asserted-by":"crossref","unstructured":"Roon AJ, Christensen N. Evaluation and treatment of penetrating cervical injuries. J Trauma. 1979;19(6):391\u2013397. https:\/\/doi.org\/10.1097\/00005373-197906000-00001","DOI":"10.1097\/00005373-197906000-00001"},{"key":"ref20","doi-asserted-by":"crossref","unstructured":"Defore WW, Mattox KL, Hansen HA, et al. Surgical management of penetrating injuries of the esophagus. Am J Surg. 1977;134(6):734\u2013738. https:\/\/doi.org\/10.1016\/0002-9610(77)90313-0","DOI":"10.1016\/0002-9610(77)90313-0"},{"key":"ref21","doi-asserted-by":"crossref","unstructured":"Schraufnagel DP, Mubashir M, Raymond DP. Non-iatrogenic esophageal trauma: A narrative review. Mediastinum. 2022;25:6\u201323. https:\/\/doi.org\/10.21037\/med-21-41","DOI":"10.21037\/med-21-41"},{"key":"ref22","doi-asserted-by":"crossref","unstructured":"Young CA, Menias CO, Bhalla S, Prasad SR. CT features of esophageal emergencies. Radiographics. 2008;28(6):1541\u20131553. https:\/\/doi.org\/10.1148\/rg.286085520","DOI":"10.1148\/rg.286085520"},{"key":"ref23","doi-asserted-by":"crossref","unstructured":"Paladino L, Baron BJ, Shan G, Sinert R. Computed tomography angiography for aerodigestive injuries in penetrating neck trauma: A systematic review. Acad Emerg Med. 2021;28(10):1160\u20131172. https:\/\/doi.org\/10.1111\/acem.14298","DOI":"10.1111\/acem.14298"},{"key":"ref24","doi-asserted-by":"crossref","unstructured":"Madsen AS, Kong VY, Oosthuizen G V, et al. Computed Tomography Angiography is the definitive vascular imaging modality for penetrating neck injury: A South African experience. Scand J Surg. 2018;107(1):23\u201330. https:\/\/doi.org\/10.1177\/1457496917731187","DOI":"10.1177\/1457496917731187"},{"key":"ref25","doi-asserted-by":"crossref","unstructured":"Gonzalez RP, Falimirski M, Holevar MR, Turk B. Penetrating zone II neck injury: Does dynamic computed tomographic scan contribute to the diagnostic sensitivity of physical examination for surgically significant injury? A prospective blinded study. J Trauma. 2003;54(1):61\u201364. https:\/\/doi.org\/10.1097\/00005373-200301000-00008","DOI":"10.1097\/00005373-200301000-00008"},{"key":"ref26","doi-asserted-by":"crossref","unstructured":"Chirica M, Kelly MD, Siboni S, et al. Esophageal emergencies: WSES guidelines. World J Emerg Surg. 2019;31:14\u201326. https:\/\/doi.org\/10.1186\/s13017-019-0245-2","DOI":"10.1186\/s13017-019-0245-2"}],"container-title":["South African Journal of Radiology"],"original-title":[],"link":[{"URL":"https:\/\/sajr.org.za\/index.php\/sajr\/article\/viewFile\/2930\/3701","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/sajr.org.za\/index.php\/sajr\/article\/viewFile\/2930\/3702","content-type":"application\/epub+zip","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/sajr.org.za\/index.php\/sajr\/article\/viewFile\/2930\/3703","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/sajr.org.za\/index.php\/sajr\/article\/viewFile\/2930\/3704","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/sajr.org.za\/index.php\/sajr\/article\/view\/2930\/3704","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T14:16:47Z","timestamp":1790173007000},"score":1,"resource":{"primary":{"URL":"https:\/\/sajr.org.za\/index.php\/sajr\/article\/view\/2930"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9,9]]},"references-count":27,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2023,12,23]]}},"URL":"https:\/\/doi.org\/10.4102\/sajr.v28i1.2930","relation":{},"ISSN":["1027-202X","2078-6778"],"issn-type":[{"value":"1027-202X","type":"print"},{"value":"2078-6778","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,9,9]]},"article-number":"a2930"}}