Inoue Tetsuji, Abe Michio
Department of Orthopaedic Surgery, Minamata City General Hospital and Medical Center , Minamata, Japan.
Department of Surgery, Minamata City General Hospital and Medical Center , Minamata, Japan.
Spinal Cord Ser Cases. 2016 Apr 7;2:15034. doi: 10.1038/scsandc.2015.34. eCollection 2016.
We report the successful conservative management of an unusual case of esophageal perforation associated with an upper thoracic spinal fracture from blunt trauma in Minamata, Kumamoto, Japan. A 69-year-old man became paraplegic secondary to an L1 burst fracture caused by a boating accident and underwent posterior fixation on the day of admission. The patient also had a minimally displaced T4 vertebral fracture. Fever, dyspnea and elevated inflammatory markers all persisted postoperatively. Computed tomography showed free mediastinal air at the T4 level, and an esophagram showed contrast medium leakage, which helped diagnose esophageal perforation. The esophageal perforation healed with conservative treatment without life-threatening complications. The possibility of esophageal injury should always be considered when treating upper thoracic spinal injuries due to blunt trauma.
我们报告了日本熊本县水俣市一例因钝性创伤导致上胸椎骨折并伴有食管穿孔的罕见病例的成功保守治疗。一名69岁男性因划船事故导致L1爆裂骨折而截瘫，并于入院当天接受了后路固定术。该患者还伴有T4椎体轻度移位骨折。术后发热、呼吸困难及炎症指标升高持续存在。计算机断层扫描显示T4水平纵隔有游离气体，食管造影显示有造影剂渗漏，这有助于诊断食管穿孔。经保守治疗，食管穿孔愈合，未出现危及生命的并发症。在治疗因钝性创伤导致的上胸椎损伤时，应始终考虑食管损伤的可能性。
