Esophageal Perforation after Fracture of the Cervical Spine in Patient with Diffuse Idiopathic Skeletal Hyperostosis(DISH) - A Case Report -

Case Report

Korean J Spine 2007;4(4): 220-223.

Dae Hyun Kim, M.D.

Department of Neurosurgery, School of Medicine Catholic University of Daegu, Daegu, Korea

증례 : Esophageal Perforation after Fracture of the Cervical Spine in Patient with Diffuse Idiopathic Skeletal Hyperostosis(DISH) - A Case Report -

Dae Hyun Kim^, M.D.

Department of Neurosurgery, School of Medicine Catholic University of Daegu, Daegu, Korea

Abstract

We present a posttraumatic esophageal tear that occurred in a 51 year old man with diffuse idiopathic skeletal hyperostosis (DISH) after rolling down into cliff, 5m in height. On physical examination, there was a facial laceration explaining hyperextension injury. The simple X-rays of cervical spine, computed tomography(CT), and magnetic resonance imaging(MRI) revealed C6-7 fracture and dislocation with cord contusion and diffuse hyperostotic bony spurs on anterolateral aspect of C3 -C7 and ossification of posterior longitudinal ligament. The diagnosis of the esophageal perforation was delayed for 3 days. The treatment consisted surgical debridement, primary closure of lacerated esophagus, antibiotic therapy, continuous drainage, and combined anterior and posterior instrumentation. If the fracture and dislocation after cervical spine injury may be found, especially in patient with diffuse idiopathic skeletal hyperostosis, we should suspect the possibility of existence of esophageal injury.

Keywords: Esophageal perforationsㆍCervical vertebraeㆍSpinal fracturesㆍDiffuse idiopathic skeletal hyperostosis