[Perforation of the cervical esophagus after ventral fusion of the cervical spine. Defect coverage by muscle-plasty with the sternocleidomastoid muscle: case report and review of the literature].
The therapy for spontaneous or artificial perforation of the esophagus remains a controversial matter. The following case report deals with the medical history of an artificial esophageal perforation after operative treatment of cervical disc disease. A 68-year-old male patient underwent a C4/C5 and C5/C6 discectomy with interbody fusion of C7-T1 vertebral body, according to Smith-Robinson. During this operation, a 3-cm-long lesion was made in the posterior wall of the esophagus, which was treated 24 h later with a primary suture. The clinical follow-up was complicated by mediastinitis with subsequent multiorgan failure. After recovery from this critical condition the patient dysphagia, which was related to a persistent lesion in the posterior esophageal wall with endoscopically demonstrated dislocation of a screw. After removal of the screw, the lesion was covered by means of sternocleidomastoid myoplasty. Moderate postoperative dysphagia was successfully treated by bougienage.
Lamesch
P
P
Klinik für Abdominal-, Transplantations-und Gefässchirurgie, Universität Leipzig.
Dralle
H
H
Blauth
M
M
Hauss
J
J
Meyer
H J
HJ
D000368:Aged; D001863:Bone Screws; D002574:Cervical Vertebrae / Q000601:surgery*; D017586:Diskectomy / Q000379:methods*; D004939:Esophageal Perforation / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D007049:Iatrogenic Disease; D007431:Intraoperative Complications / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000601:surgery; D011859:Radiography; D012086:Reoperation; D013123:Spinal Fusion / Q000379:methods*; D013524:Surgical Flaps / Q000379:methods*; D013536:Suture Techniques