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Hypopharyngeal perforation caused by blunt trauma in buffalo attack
  1. Jack Peter Archer,
  2. Madison Rose Boot and
  3. Camille Jardeleza
  1. Wagga Wagga Base Hospital, Wagga Wagga, New South Wales, Australia
  1. Correspondence to Dr Jack Peter Archer; jparcher0{at}


A male in his 50s arrived by ambulance at a regional Australian hospital after being pinned by a buffalo against a fence by the chest and abdomen. Primary and secondary surveys identified an open fibula fracture and superficial abrasions. CT trauma series identified retropharyngeal free gas extending to the right carotid sheath. Flexible nasoendoscopy revealed a normal upper airway and no site of perforation. Oesophagoscopy and gastroscopy were completed to evaluate for a site of free gas leakage. A hypopharyngeal tear was identified 15 cm from the incisors at the cricopharyngeal sphincter. A gastrograffin swallow was completed which showed no leak. The decision was made to manage the patient conservatively with intravenous dexamethasone and intravenous ceftriaxone/metronidazole for antibiotic prophylaxis. The patient had his diet gradually upgraded and was discharged home 4 days later with oral amoxicillin and clavulanic acid.

  • General surgery
  • Surgery
  • Radiology
  • Gas/Free Gas

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  • Contributors JPA completed the majority of the work involved with this paper including conception, consenting patients, writing case and editing. MRB completed core components including literature searches, referencing and editing. CJ provided editing and feedback, in conjunction with clinical expertise.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.