SPINAL INFECTION WITH MEDIASTINITIS SECONDARY TO ESOPHAGEAL INJURY BY A PROMINENT OSTEOPHYTE IN A PATIENT WITH DIFFUSE IDIOPATHIC SKELETAL HYPEROSTOSIS

DOI
  • CHAN Minnie
    Department of Disaster and Emergency Medicine, Kobe University
  • TAKAOKA Makoto
    Hyogo Prefectural Harima-Himeji General Medical Center, Acute Care Division

Bibliographic Information

Other Title
  • びまん性特発性骨増殖症の骨棘による食道穿孔から脊椎感染症に進展した一例

Abstract

<p>　　A man in his 80s with a history of diabetes, hypertension, and angina pectoris was admitted to the hospital after he hit his face against a “fusuma” door and subsequently complained of back pain. Magnetic resonance imaging (MRI) revealed retropharyngeal hematoma with diffuse idiopathic skeletal hyperostosis (DISH) and anteriorly projecting C7-Th1 osteophytes. Several days later, the patient presented with septic shock secondary to mediastinitis. Esophagogastroduodenoscopy demonstrated an esophageal perforation adjacent to the osteophytes, which was treated conservatively. About one month later, the patient presented with sudden-onset sustained C7-Th1 spondylodiscitis, epidural abscess, and intramedullary spinal cord abscess, resulting in persistent paraplegia. DISH is typically asymptomatic ; however, esophageal injury by prominent osteophytes may occur with neck hyperextension, highlighting the possibility of complicating spinal infection in patients with mediastinitis. MRI is useful for early diagnosis and understanding the pathophysiology in such patients.</p>

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Keywords

Details 詳細情報について

  • CRID
    1390862943886567040
  • DOI
    10.11382/jjast.38.3_09
  • ISSN
    21880190
    13406264
  • Text Lang
    ja
  • Data Source
    • JaLC
  • Abstract License Flag
    Disallowed

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