A Rare Cause of Epidural Abscess: Esophageal Perforation After Radiotherapy

Abstract

Introduction:
 Spinal epidural abscess is a rare neurosurgical emergency that is usually seen invasive interventions to the spinal region, trauma or infection. In our case, anteriorly located spinal epidural abscess, which is caused by spontaneous esophageal rupture as complication of radiotherapy, is described.
 Case report:
 A 60-year-old female patient was admitted to the emergency department with complaints of confusion, high fever and weakness in both legs. The patient had been treated for lung metastasis of breast cancer with radiotherapy. Spinal anterior epidural abscess was observed in the spinal imaging, and it was considered that the abscess developed after esophageal rupture secondary to radiotherapy. After surgery the patient had antibiotic treatment during the postoperative period. Although there are cases of spinal epidural abscess that developed after esophageal rupture in the literature, they were generally observed after interventions to the esophagus or trauma to the chest. In our case, epidural abscess developed after radiotherapy, that caused esophageal rupture, was presented.
 Conclusion:
 Clinicians should consider spinal epidural abscess, which is a rare complication in patients with walking difficulties after radiotherapy, in the differential diagnosis.