Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Smolle, MA; Maier, A; Lindenmann, J; Porubsky, C; Seibert, FJ; Leithner, A; Smolle-Juettner, FM.
Esophageal perforation with near fatal mediastinitis secondary to Th3 fracture.
Wien Klin Wochenschr. 2024; 136(19-20):575-580
Doi: 10.1007/s00508-024-02397-3
(- Case Report)
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- Führende Autor*innen der Med Uni Graz
- Lindenmann Jörg
- Smolle Maria Anna
- Co-Autor*innen der Med Uni Graz
- Leithner Andreas
- Maier Alfred
- Porubsky Christian
- Seibert Franz
- Smolle-Juettner Freyja-Maria
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- Abstract:
- A 74-year-old male patient was referred with signs of sepsis 5 days after having been diagnosed with a rib fracture following a fall out of bed. Novel hypodensities were visible on thoracic X‑rays and laboratory tests revealed elevated inflammatory parameters. Subsequently performed thoracic computed tomography (CT) scan showed burst fracture of the 3rd thoracic vertebra, posttraumatic esophageal rupture at the same level and mediastinitis. Furthermore, marked degenerative changes of the spinal column (diffuse idiopathic skeletal hyperostosis) were present. The patient underwent emergency thoracotomy and esophagectomy. Gastric pull-up with esophagogastrostomy was postponed for 3 days. After 14 days on the intensive care unit (ICU) and 12 days of i.v. antibiotics, the patient was transferred to the general ward and 7 weeks after trauma the patient was infection-free without difficulties in swallowing. Up to the latest follow-up 41 months following injury, several endoscopic dilations with a bougie due to constrictions at the anastomosis have been performed. Similar to previous cases in the literature, esophageal injury was diagnosed delayed, with the patient already having developed severe complications. This extremely seldom injury should be suspected in young patients following high-energy trauma, but also in older patients after low-energy trauma but known degenerative changes of the vertebral column.
- Find related publications in this database (using NLM MeSH Indexing)
- Humans - administration & dosage
- Male - administration & dosage
- Aged - administration & dosage
- Mediastinitis - etiology, diagnosis
- Esophageal Perforation - etiology, diagnostic imaging, diagnosis, surgery
- Thoracic Vertebrae - injuries, surgery, diagnostic imaging
- Spinal Fractures - complications, surgery, diagnostic imaging
- Treatment Outcome - administration & dosage
- Esophagectomy - administration & dosage
- Diagnosis, Differential - administration & dosage
- Find related publications in this database (Keywords)
- Esophageal injury
- Diffuse idiopathic skeletal hyperostosis
- Vertebral fracture
- Esophagogastrostomy
- Trauma