Esophageal Perforation after Thoracic Vertebral Fracture in an Ankylosed Spine: Case Report and Review of the Literature

Abstract

We present the case of a 74 year-old male with delayed diagnosis of post-traumatic thoracic esophageal perforation that occurred secondary to thoracic vertebral fracture in an ankylosed spine. The injury resulted after a fall from chair secondary to an unconscious collapse due to Ventricular Fibrillation (VF). At 8 days after the injury, the patient was diagnosed with esophageal perforation, secondary to fourth thoracic vertebral fracture without neurological deficit. The esophageal laceration was complicated by sepsis with bacteremia, pleural empyema and mediastinal abscess. Non-surgical management for the esophageal perforation, chest complications and thoracic spine fracture resulted in complete recovery. A case report and review of the literature is presented. We report the first case of post-traumatic thoracic esophageal perforation secondary to thoracic T4 vertebral fracture, in a patient with an ankylosed spine that survived neurologically intact after successful conservative management.