Esophageal fistula secondary to migration of an anterior cervical fixation screw.

Abstract

We present the case of a 50 years-old woman, with cervical fixation surgery 16 years ago because of a traffic accident, that arrives with the oral expulsion of an screw. She also relates dysphagia, odynophagia and purulent secretions. The cervical X-ray shows the absence of the left superior screw of the fixation plate. In the cervical CT we observe an esophageal fistula and virtual cavity, and the nasofibrolaryngoscopy shows retrocricoid and right arytenoid protrusion with salivary regurgitation. We decide to set up prophylactic antibiotherapy and parenteral diet. An esophagogram is required a week later where a cavity is seen at C5-C6 level, that connects the esophagus to the prevertebral region. Oral diet is set up 21 days after the admission, with good response and hospital discharge 4 days after, staying asymptomatic one year and a half afterwards.