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Inicio Acta Otorrinolaringológica Española Spinal-esophageal Fistula in a Patient Treated With Concurrent Chemotherapy and ...
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Vol. 63. Issue 3.
Pages 241-243 (May - June 2012)
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Vol. 63. Issue 3.
Pages 241-243 (May - June 2012)
Case Study
Spinal-esophageal Fistula in a Patient Treated With Concurrent Chemotherapy and Radiotherapy
Fístula esófago-espondilorraquídea en paciente tratado con radioterapia y quimioterapia
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Álvaro Cordero-Jiménez
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alvarocorderoj@gmail.com

Corresponding author.
, Rafael Tenor-Serrano, Carlos Muñoz-Palza, José Rafael Solano-Romero
Servicio de Otorrinolaringología, Hospital Clínico Universitario Virgen de la Victoria, Málaga, Spain
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Abstract

We present the case of a 56-year-old male patient with a history of glottic carcinoma treated with concurrent chemotherapy and radiotherapy in complete remission, who went to hospital with severe neck pain, upper right limb weakness and dysphagia. Physical examination showed neck stiffness as well. Spondylitis at C6–C7 spinal level with extradural abscess formation was diagnosed by MRI. Barium radiography revealed an esophageal ulcer with a posterior sinus path. Conservative treatment was given with percutaneous gastrostomy and antibiotics. The patient's symptoms improved and the fistula and the abscess had disappeared in the later MRI control studies.

Keywords:
Spinal esophageal fistula
Radiotherapy adverse effects
Extradural abscess
Resumen

Varón de 56 años con antecedente de carcinoma glótico tratado con quimioterapia y radioterapia concomitante en remisión completa. Acude a urgencias por cervicalgia intensa, paresia de miembro superior derecho y disfagia. La exploración física muestra además rigidez cervical. Se realiza resonancia magnética donde se objetiva espondilitis a nivel vertebral C6-C7 con formación de un absceso extradural que comprime la médula. Un tránsito baritado muestra una úlcera esofágica con trayecto fistuloso posterior. Se realiza tratamiento conservador con gastrostomía percutánea y antibioticoterapia. El paciente mejora ostensiblemente de sus síntomas y en los estudios de imagen de control se objetiva la desaparición de la fístula.

Palabras clave:
Fístula esófago-raquídea
Efectos adversos radioterapia
Absceso extradural

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