Regional Department of Thoracic Surgery, Birmingham Heartlands Hospital, Bordesley Green, Birmingham, UK.
Dis Esophagus. 2010 Jan;23(1):E5-8. doi: 10.1111/j.1442-2050.2009.01009.x. Epub 2009 Aug 28.
Esophageal perforation is a difficult problem in thoracic surgery. Esophageal perforations can be spontaneous, iatrogenic, or malignant. We report two cases of esophageal perforations caused by thoracic osteophytes and different management strategies leading to successful outcomes. An 80-year-old male presented with chest pain and dysphagia following a fall. On endoscopy, an esophageal perforation and foreign body was noted which was confirmed as a thoracic osteophyte on computed tomography scan. He was managed conservatively as he declined surgery. A 63-year-old male was admitted with dysphagia following a food bolus obstruction. Following esophagoscopy and dilatation, there was clinical and radiological evidence of perforation. During surgery, a thoracic osteophyte was identified as the cause of perforation. The perforation was closed in layers and the osteophyte was trimmed. Both patients recovered well. Thoracic osteophytes are a rare cause of esophageal perforations and a high index of suspicion is required in patients with osteoarthritis who present with esophageal perforations.
食管穿孔是胸外科的一个难题。食管穿孔可分为自发性、医源性和恶性穿孔。我们报告两例由胸肋关节炎引起的食管穿孔，并采用不同的管理策略取得了成功的结果。一名 80 岁男性在跌倒后出现胸痛和吞咽困难。内镜检查发现食管穿孔和异物，计算机断层扫描（CT）扫描证实为胸肋关节炎。由于他拒绝手术，因此采用保守治疗。一名 63 岁男性因食物团块梗阻后出现吞咽困难而入院。食管镜检查和扩张后，出现穿孔的临床和放射学证据。在手术中，发现胸肋关节炎是穿孔的原因。穿孔被分层关闭，骨赘被修剪。两名患者均恢复良好。胸肋关节炎是食管穿孔的罕见原因，对于患有骨关节炎并出现食管穿孔的患者，需要高度怀疑。
