[Anterior spinal artery syndrome after thoraco-abdominal esophagus resection. A rare complication].
We report a case of postoperative paraplegia resembling an anterior spinal artery syndrome after curative esophagectomy in a patient with carcinoma of esophagus and clinical stage III (UICC). Neurologic deficit was characterized by loss of sensibility at the level of T12/L1 together with paraparesis of both lower extremities. Furthermore, dissociated sensorimotor depletion at C6/C7 (right-sided) and at T5 (left-sided) was noted. This severe complication was most probably caused by peeling of an arteriosclerotic plaque of the thoracic aorta due to preexisting advanced arteriosclerosis, leading to a partial occlusion of the great radicular artery of Adamkiewicz. Even though anterior spinal artery syndrome is a well-known problem in the operative management of thoracic aortic aneurysms, this complication has not previously been reported after esophagectomy.
Boedeker
H
H
Klinik und Poliklinik für Chirurgie, Universität Regensburg.
Schmidt
J
J
Zirngibl
H
H
D000328:Adult; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery*; D004938:Esophageal Neoplasms / Q000473:pathology / Q000601:surgery*; D016629:Esophagectomy; D005500:Follow-Up Studies; D006801:Humans; D007511:Ischemia / Q000209:etiology*; D007813:Laparotomy; D008197:Lymph Node Excision; D008297:Male; D009367:Neoplasm Staging; D009460:Neurologic Examination; D010264:Paraplegia / Q000209:etiology*; D011183:Postoperative Complications / Q000209:etiology*; D013116:Spinal Cord / Q000098:blood supply*; D013908:Thoracotomy