Oesophageal Perforation after Anterior Cervical Spine Fixation: An Unusual Combination of Predisposing Factors.

Abstract

A case of oesophageal perforation is being reported following anterior cervical plating in burst facture of C5 vertebra (Frankel Grade A) at 2 weeks following surgery. The multiple etiological factors responsible possibly are proud implant, subtle surgical insult during surgery and an unusual predisposing factor of early intake of solid diet postoperatively, i.e. second postoperative day. No similar report addressing to the issue was found. The diagnosis was confirmed by gastrograffin swallow and oesophagoscopic study. The adequate trial of conservative treatment was given, failing which reexploration, removal of implant, repair of oesophagus and sternocleidomastoidoplasty with feeding jejunostomy was carried out. Patient responded well to treatment and started tolerating solid diet. The patient died 195 days after admission due to a massive intestinal bleed which could probably be drug induced.

Keywords: Esophageal perforation; Cervical spine; Trauma

Nigerian Journal of Orthopaedics and Trauma Vol. 6 (2) 2007: pp. 91-93