Esophageal perforation in a patient with diverticulum following anterior discectomy and fusion

October 23, 2013
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Dysphagia Clinic

 Most perforations are thought to result from esophageal retraction, direct injury during manipulation, hardware failure, or movement of cervical vertebral bodies during hyperextension.

A 42-year-old man was referred to us with a 6-month history of dysphagia and regurgitation. He reported a 38-pound weight loss, and serum prealbumin indicated protein malnutrition at 17 mg/dl. He had a complex surgical history at an outside hospital, including anterior cervical discectomy and fusion (ACDF) in 2006 complicated by intraoperative esophageal perforation. Subsequently, multiple surgical attempts at repair were made. Recovery was prolonged by the patient's refusal to remain NPO.

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