Ösophagusperforationen durch HWS-Osteosynthesematerial - seltene Differenzialdiagnose einer Dysphagie

M. Kleemann; S. Lipinski; P. Hildebrand; H.-P. Bruch; B. C. Manegold

doi:10.1055/s-2007-960563

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Endoskopie heute 2007; 20(1): 50-54
DOI: 10.1055/s-2007-960563

Originalarbeit

Ösophagusperforationen durch HWS-Osteosynthesematerial - seltene Differenzialdiagnose einer Dysphagie

Esophageal Perforations Caused by Cervical Spine Osteosynthesis - a Rare Differential Diagnosis of DysphagiaM. Kleemann¹ , S. Lipinski² , P. Hildebrand¹ , H.-P. Bruch¹ , B. C. Manegold³

¹Klinik für Chirurgie, Universitätsklinikum Schleswig Holstein, Campus Lübeck
²Universität Lübeck, Medizinische Fakultät, Lübeck
³Sektion Endoskopie und Sonographie der Chirurgischen Klinik, Universitätsklinikum Mannheim

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Publication Date:
16 March 2007 (online)

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Zusammenfassung

Dysphagie ist ein Alarmsymptom, das stets der Abklärung bedarf. Seltene Ursache der Dysphagie ist die Arrosion des Ösophagus von außen. Wir berichten über zwei Fälle von Ösophagusperforationen durch Osteosynthesematerial: bei einem 88-jährigen Patienten sieben Jahre nach ventraler Spondylodese von C 5-7 und bei einer 66-jährigen Patientin ein Jahr nach Korporektomie und HWK-Ersatz von C 2 bis Th 2 durch einen Titankorb. Die Arrosion mit Perforation des Ösophagus ist eine wohl bekannte Komplikation in der Chirurgie degenerativer, traumatischer oder neoplastischer Halswirbelsäulenleiden. Ihre Therapie sollte in erster Linie chirurgisch erfolgen. In Ausnahmefällen z. B. bei hohem Operationsrisiko, kann auch konservativ vorgegangen werden.

Abstract

Dysphagia is a severe symptom that has to be clarified. A rare cause of dysphagia is the perforation of the esophagus. We report about two cases of perforations of the esophagus from osteosynthesis material: in an 88-year-old patient 7 years after ventral cervical spondylodesis of C 5-7 and in a 66-year-old female one year after corporectomy and replacement of cervical spine corps of C 2-Th 2 by a titanium basket. Arrosion with perforation of the esophagus is a (rare but) well known complication in surgical therapy of degenerative, traumatic or neoplasmatic cervical spine diseases. Surgery should be first line therapy. In exceptional cases for example with a high surgical risk it may be treated conservatively.

Schlüsselwörter

Ösophagusperforation - Ösophagusarrosion - Dysphagie - zervikale ventrale Spondylodese

Key words

esophagus perforation - esophagus arrosion - dysphagia - ventral cervical spondylodesis

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Dr. med. M. Kleemann

Klinik für Chirurgie · Universitätsklinikum Schleswig-Holstein · Campus Lübeck

Ratzeburger Allee 160

23538 Lübeck

Phone: 04 51 / 5 00 20 01

Fax: 04 51 / 5 00 20 69

Email: markus.kleemann@ukl.uni-luebeck.de