title: Extrinsic Esophageal Compression by Cervical Osteophytes in Diffuse Idiopathic Skeletal Hyperostosis: A Contraindication to Transesophageal Echocardiography?
abstract: Contraindications to transesophageal echocardiography (TEE) include various esophageal pathologies, but compression of the esophagus by vertebral osteophytes is not listed in the current American Society of Echocardiography guidelines. We report a case of diffuse idiopathic skeletal hyperostosis (DISH) in an 81-year-old man who had incidentally been found to have extrinsic esophageal compression by cervical osteophytes prior to a proposed TEE. The incidence of esophageal perforation in patients with DISH and vertebral osteophytes is not well documented. We believe these patients are at increased risk of esophageal perforation during TEE, and thus, TEE may be relatively contraindicated in patients with DISH.
authors.affiliation: Leon H. Charney Division of Cardiology, New York University School of Medicine, New York, New York.
authors.forename: Kevin
authors.initials: K
authors.lastname: Chang
authors.affiliation: Leon H. Charney Division of Cardiology, New York University School of Medicine, New York, New York.
authors.forename: Maya
authors.initials: M
authors.lastname: Barghash
authors.affiliation: Leon H. Charney Division of Cardiology, New York University School of Medicine, New York, New York.|Veterans Affairs New York Harbor Healthcare System, New York, New York.|Department of Radiology, New York University School of Medicine, New York, New York.
authors.forename: Robert
authors.initials: R
authors.lastname: Donnino
authors.affiliation: Leon H. Charney Division of Cardiology, New York University School of Medicine, New York, New York.
authors.forename: Robin S
authors.initials: RS
authors.lastname: Freedberg
authors.affiliation: Department of Radiology, New York University School of Medicine, New York, New York.
authors.forename: Mari
authors.initials: M
authors.lastname: Hagiwara
authors.affiliation: Department of Radiology, New York University School of Medicine, New York, New York.
authors.forename: Genevieve
authors.initials: G
authors.lastname: Bennett
authors.affiliation: Leon H. Charney Division of Cardiology, New York University School of Medicine, New York, New York.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Benenstein
authors.affiliation: Leon H. Charney Division of Cardiology, New York University School of Medicine, New York, New York.
authors.forename: Muhamed
authors.initials: M
authors.lastname: Saric
mesh_terms: D000369:Aged, 80 and over; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging*; D017548:Echocardiography, Transesophageal; D016145:Endoscopy, Digestive System; D006801:Humans; D004057:Hyperostosis, Diffuse Idiopathic Skeletal / Q000150:complications* / Q000000981:diagnostic imaging*; D008297:Male; D054850:Osteophyte / Q000150:complications* / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed
keywords: cervical osteophytes; compression; diffuse idiopathic skeletal hyperostosis; esophagus; transesophageal echocardiography